Indications for contralateral opacification application in the context of antegrade recanalization of coronary hronic total occlusions (CTO).

Shakhov B.E., Chebotar’ E.V., Ryazhskikh A.I., Shumakov I.V., Nagaev R.Y. I

Purpose. To define the indications for contralateral opacification application in the context of antegrade recanalization of coronary chronic total occlusions. Materials and methods. The study included 128 patients with coronary chronic total occlusions undergoing antegrade recanalization. The variants of collateral blood flow in post occlusion segments were analyzed by means of ipsi- and contralateral opacification. The analysis of the impact of post occlusion segment visualization on the result of endovascular intervention was carried out. Results. Suggested retrograde artery image (RAI) classification of collateral blood flow allows to describe the variants of post occlusion segment opacification in a more precise way while, as opposed to other classifications, RAI classification gives information about visuali-zation of a distal stump. There was identified a correlation between recanalization success and blood flow types RAI-Ia, RAI-III which are characterized by distal stump opacification. It was as well discovered that complications were more frequent with blood flow types RAI-0, RAI-Ib, RAI-II. Application of contralateral opacification turned out to be necessary in 27% cases of antegrade recanalization and was due to insufficient post occlusion segment opaci-fication by means of ipsilateral contrast medium injection. It was also found that more expe-rienced surgeons used contralateral opacification reliably more often in case of less than ½ post occlusion segment visualization as well as in case of distal stump nonvisualization. Conclusions. Success of antegrade recanalization of coronary chronic total occlu-sions was reached with blood flow visualization types RAI-Ia, RAI-III. Nonvisualization of a distal stump by means of ipsilateral opacification serves the indicator for contralateral opac-ification application.

1 - State Educational Institution of Higher Professional Training "Nizhny Novgorod State Medical Academy of the Federal Agency for Public Health and Social Development". 2 - Specialized Hospital for Cardiac Surgery. Nizhny Novgorod, Russia.

 

 

 

 

 

Keywords: coronary chronic total occlusions, collateral blood flow, distal stump, ipsilateral opacification, contralateral opacification, coronary collateral blood flow classification.

 

Corresponding author:Ryazhskikh A.I., Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: : Shakhov B.E., Chebotar’ E.V., Ryazhskikh A.I., Shumakov I.V., Nagaev R.Y. Indications for contralateral opacification application in the context of antegrade recanalization of coronary hronic total occlusions (CTO). REJR. 2017; 7 (3):69-82. DOI:10.21569/2222-7415-2017-7-3-69-82./em>

Received: 23.05.2017 Accepted:17.07.2017