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Background And Aim: Interventional cardiologists face challenges in managing chronic total occlusion (CTO) lesions, with conflicting results when comparing rotational atherectomy (RA) to conventional PCI. This meta-analysis aims to provide a critical evaluation of the safety and feasibility of RA in CTO lesions.
Methods: PubMed, Scopus, Web of Science, Ovid, and Cochrane central library until April 2023 were searched for relevant studies. MACE was our primary outcomes, other outcomes were all cause of death, cardiac death, MI, and TVR. Also, we reported angiographic outcomes as technical success, procedural success, and procedural complications in a random effect model. The pooled data was analyzed using odds ratio (OR) with its 95% CI using STATA 17 MP.
Results: Seven studies comprising 5494 patients with a mean follow-up of 43.1 months were included in this meta-analysis. Our pooled analysis showed that RA was comparable to PCI to decrease the incidence of MACE (OR = 0.98, 95% CI [0.74 to 1.3], p = 0.9). Moreover, there was no significant difference between RA and conventional PCI in terms of other clinical or angiographic outcomes.
Conclusion: Our study showed that RA had comparable clinical and angiographic outcomes as conventional PCI in CTO lesions, which offer interventional cardiologists an expanded perspective when addressing calcified lesions.
Prospero Registration: CRD42023417362.
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http://dx.doi.org/10.1186/s12872-023-03673-2 | DOI Listing |
AJNR Am J Neuroradiol
September 2025
From the Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America (J.S.S., B.M., S.H., A.H., J.S.), and Department of Aerospace Engineering, Indian Institute of Technology Madras, Chennai, Tamil Nadu, India (H.S.).
Background And Purpose: The choroid of the eye is a rare site for metastatic tumor spread, and as small lesions on the periphery of brain MRI studies, these choroidal metastases are often missed. To improve their detection, we aimed to use artificial intelligence to distinguish between brain MRI scans containing normal orbits and choroidal metastases.
Materials And Methods: We present a novel hierarchical deep learning framework for sequential cropping and classification on brain MRI images to detect choroidal metastases.
Eur Heart J Case Rep
September 2025
Cardiovascular Division, National Hospital Organization Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka 540-0006, Japan.
Background: Guide extension catheters are specially designed for percutaneous coronary intervention (PCI) to enhance backup support of the guide catheter by providing coaxial alignment, thereby allowing deep intubation of the catheter. We have developed an innovative auxiliary support technique utilizing a dual guide extension catheter system, designed to enhance safety and facilitate deep coronary artery access.
Case Summary: A male in his sixties who presented with chest pain was diagnosed with non-ST elevation myocardial infarction.
Cardiovasc Revasc Med
August 2025
Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, 6565 Fannin St, Houston, TX 77030, United States of America. Electronic address:
Background: Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) remains technically challenging, with ongoing debate about procedural success predictors and long-term outcomes. We report real-world data from the Houston Methodist CTO PCI Registry to characterize procedural success, safety, and mid- to long-term outcomes.
Methods: We retrospectively analyzed 507 patients undergoing CTO PCI between 2018 and 2023.
Catheter Cardiovasc Interv
August 2025
Heartcenter Lahr, Lahr, Germany.
Background: High radiation exposure is a significant risk with recanalizations for chronic total coronary occlusions (CTO).
Aims: To analyze the influence of radiographic equipment, radiation protocols, and operator experience on radiation exposure.
Methods: We analyzed 17,769 procedures by 27 operators from a multicenter European Registry between 2015 and 2023.
Clin Res Cardiol
August 2025
Division of Cardiology, Tel Aviv Sourasky Medical Center, affiliated with the Tel Aviv University School of Medicine, Tel Aviv, Israel.
Background: Coronary chronic total occlusion (CTO) is a common cause of refractory angina, and impaired quality of life. Coronary sinus reducer (CSR) implantation is a safe and effective therapy for patients with refractory angina.
Aim: To evaluate the clinical efficacy of reducer implantation to relieve angina in patients with CTO.