The Medical Acronym /Abbreviation/Slang CTO means Chronic Total Occlusion. Two guide catheters are placed to allow for dual coronary injection. Although there are no randomized controlled clinical trials of CTO PCI vs. either medical therapy or CABG, there are increasing data that suggest successful CTO PCI … The Licensed Content is the property of and copyrighted by DSM. The main tools for this strategy include the Crossboss or a knuckle wire. 608-10. 101. The antegrade wire is advanced using the retrograde wire as a target. Till now you might have got some idea about the acronym, abbreviation or meaning of CTO (Meta-analysis of successful versus failed CTO PCI, demonstrating improvements in mortality and quality of life with reduction in myocardial infarction with successful recanalization. A chronic total occlusion (CTO) is defined as the complete obstruction of a coronary artery, exhibiting TIMI 0 or TIMI 1 flow, with an occlusion duration of >3 months. The presence of hemodynamic support systems including intraaortic balloon pumps and/or percutaneous LVADs are extremely important in cases of shock or cardiac arrest. A CTO means that you must keep to certain conditions. 1-11. “Multicentre experience with the BridgePoint devices to facilitate recanalisation of chronic total coronary occlusions through controlled subintimal re-entry”. Managing guides is important, especially when a long wire has been externalized causing damping and increasing the risk for dissection. Traffic plan devised for Youm-e-Ashur The antegrade guidewire crossed the CTO through the space made by the retrograde guidewire. It is important not to pan during the initial picture to allow for easier identification of the collaterals and their course. Dilating the septal collateral (this cannot be done if using an epicardial collateral) with a 1.5 mm balloon may allow easier passage of equipment. Compared with non-CTO PCI, the success rate of CTO PCI has been quoted as low as 50% versus 97%, where success is defined as TIMI 3 flow. CTO synonyms, CTO pronunciation, CTO translation, English dictionary definition of CTO. If a distal branch or vessel perforation occurs, it may be more subtle, and can be treated with embolization. 2010. pp. “Rationale and design of EXPLORE: a randomized, prospective, multicenter trial investigating the impact of recanalization of a chronic total occlusion on left ventricular function in patients after primary percutaneous coronary intervention for acute ST-elevation myocardial infarction”. The goal is to advance antegrade through the subintimal space. The placement of long femoral sheaths improves passive guide support and minimizes iliac tortuosity. If after 60 seconds the wire does not cross the occlusion directly, another wire is chosen. (Supports the mortality benefit of CTO PCI. The stingray balloon appears as two radiopaque ports that can be identified on fluoroscopy. Patients who derive the greatest benefit from revascularization are those with the largest burden of ischemia, even in the absence of symptoms. by AcronymAndSlang.com Patients with CTOs are generally referred for angiography for refractory angina or a significant ischemic burden on noninvasive stress testing. Perforation is the third major complication involving vessel injury. A nontraumatic wire may then replace the initial wire so that distal wiring may be accomplished without additional trauma to the vessel. “Improvement in survival following successful percutaneous coronary intervention of coronary chronic total occlusions: variability by target vessel”. 2011. pp. Like any medical procedure there are risks to know about. Second, if the CTO were a lesion you knew you open easily, like a 95% proximal stenosis, would you hesitate to attempt it? ), Close more info about Chronic Total Occlusions, General description of procedure, equipment, technique, Details of how the procedure is performed, Lesion Crossing and Lumen Reentry Technologies, Outcomes (applies only to therapeutic procedures), Alternative and/or additional procedures to consider, Cardiac Implantable Electrical Devices: Management of Complications; Indications for Lead Extraction. Cardiac mortality is in part a function of the myocardium at ischemic risk in patients treated with medical therapy. There are, however, complications and risks that are more common or specific to CTO cases. If the occlusion is relatively short and seemingly well defined, a heavy weight, high puncture force CTO-specific crossing wire such as the Confianza Pro 12 (Asahi) should be used. What is the meaning of CTO?. CTO (Chief Technology Officer) job description. Meaning ***** CTO: Chronic Total Occlusion Common Medical **** CTO: Community … What does Medical CTO stand for? Simultaneous injection is extremely important to assess the distal cap and to identify collaterals. Also of importance is the ability to delineate the vessel in a retrograde manner, decreasing the opportunity for hydraulic enlargement of a dissection plane during antegrade injection in the setting of dissection reentry. The pay or CTO should be paid at the correct rate of time and a half. With the emergence of novel techniques and advanced equipment, technical difficulties have become much less limiting. Banks package and sell their receivables on debt to investors in order to reduce the risk of loss due to default. There may be more than one meaning of CTO, so check it out all meanings of CTO one by one. Septal collaterals should be used by inexperienced operators before attempting the use of epicardial collaterals because of the higher risk of complications with the latter, including perforation. Till now you might have got some idea about the acronym, abbreviation or meaning of CTO Once the retrograde wire is in the true lumen it can be advanced into the anterograde guide catheter or captured with a snare. Now, given the routine success of the procedure, the indications for treatment have been more completely outlined. Contemporary appropriateness criteria, coupled with safety guidelines, have commenced a new era of percutaneous intervention, targeting a well-defined subset with groundbreaking ideas and technology. DR. DEVINDER KUMAR M.D. Longer-term leave of absence may not be granted to a patient unless the responsible clinician first considers whether the patient should be discharged on a CTO (s17(2A)). Occlusions greater than 20 mm are associated with increased procedure times and decreased success rates, and may benefit from an alternative technique from the primary. “Retrograde techniques and the impact of operator volume on percutaneous intervention for coronary chronic total occlusions an early U.S. experience”. The Finecross™ (Terumo Corp.) and Quick-Cross™ (Spectranetics Corp., Colorado Springs, CO) catheters are useful for wire support and exchange. ), (Meta-analysis of the patency rates and outcomes of CTOs treated with drug-eluting stents. 7. Hop on to get the meaning of CTO. Meaning; CTO: Chronic Total Occlusion: CTO: Coal-to-Olefins (process) CTO: Community Treatment Order (psychiatric term for forced drugging outside hospital context) If the lesion is long but the proximal and distal cap remain clear, antegrade dissection reentry should be the primary strategy. A chief technology officer (CTO) is an executive who is responsible for the management of an organization's research and development (R&D) as well as its technological needs. (Meta-analysis of the patency rates and outcomes of CTOs treated with drug-eluting stents. CTO cases have been plagued with difficulties including inability to cross the lesion and deliver stents, increased use of resources, and up to 2 times the procedure and fluoroscopy time compared with non-CTO percutaneous coronary intervention (PCI). In terms of morbidity, patients undergoing revascularization of CTO show improved tolerance to subsequent acute myocardial infarction (AMI), most likely due to complete revascularization. It’s one way that we’re helping to make clinical trials more efficient. 96. CTO claims are submitted under independent consideration, meaning they are flagged to the attention of the claims assessor and generally take longer to pay. Medical therapy of these lesions comes with a higher 1- and 5-year mortality compared with revascularization with PCI or surgery. The meaning of the CTO is also explained earlier. If a subintimal/subadventitial position is attained beside the true lumen, reentry is performed. ), Wu, EB, Chan, WW, Yu, CM. ), (Meta-analysis of successful versus failed CTO PCI, demonstrating improvements in mortality and quality of life with reduction in myocardial infarction with successful recanalization. Predictors of antegrade failure include long lesions, a small distal target, a side branch that is flush with the proximal cap or a bifurcation at the distal cap. The Tornus™ microcatheter (Asahi Intecc) has a braided wire mesh over the wire microcatheter with left-handed thread allowing for channel preparation and lesion crossing in resistant occlusions. No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. JACC Cardiovasc Interv. The meaning of the CTO is also explained earlier. In a Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial subset, rates of death were directly related to percentage of ischemic myocardium, with myocardium at risk measured by nuclear single-photon emission computed tomography (SPECT) imaging. Also, all CTO claims must be submitted with a CTO log , a form to fill out and send in with the manual review … It is usually of less consequence when involving only a wire, but becomes a bigger issue when larger equipment, such as a microcatheter, exits the vessel. The Crossboss™ catheter (BridgePoint Medical) is a metal over-the-wire microcatheter with a rounded tip to prevent vessel exit. All content on this website, including dictionary, thesaurus, literature, geography, and other reference data is for informational purposes only. A controlled dissection is used as a bridge to connect the proximal and distal true lumens by bypassing the occlusion. 539-42. All content on this website, including dictionary, thesaurus, literature, geography, and other reference data is for informational purposes only. necessarily mean that the patient should be discharged onto a CTO rather than discharged. Additionally, asymptomatic patients with good exercise tolerance are generally not candidates for CTO intervention, at least based on present data. one by one.. CTO definition / CTO means?. one by one.. CTO definition / CTO means?. Coronary chronic total occlusions (CTOs) are lesions with thrombolysis in myocardial infarction (TIMI) 0 flow for ≥3 months 1 and are commonly found in patients undergoing coronary angiography (in 18.4% to 52%). A report on behalf of the euroCTO club”. Banks package and sell their receivables on debt to investors in order to reduce the risk of loss due to default. 2009. pp. vol. Rate it: CTO: Configure To Order. Predictors of retrograde success include a visible collateral, less than 90% tortuosity of the collateral, and less than a 90-degree angle at the anastomosis between the collateral and the CTO vessel. Your responsible clinician (RC) will write down your conditions for you. vol. EuroIntervention. A time to shine: with CIOs focused on broad strategies, CTOs … What is CTO? Historically, due to lesion complexity, the patients with CTOs were turned away. Pulmonary arteries carry deoxygenated blood from the right ventricle to the lungs to pick up oxygen and to release carbon dioxide; in contrast, systemic arteries carry oxygenated blood from the left ventricle to the rest of the body. 2010. pp. AAO – acute aortic occlusion . From the table above, you can view all meanings of CTO: some are educational terms, the other are medical terms, and even computer terms. Many patients with a CTO will develop The initial views will aid in determination of the primary and alternative strategy. CTO definition / CTO means? The most important characteristics to note when studying a CTO are (1) identification of the proximal cap, (2) lesion length, (3) presence of branches as well as size and quality of the distal cap, and (4) suitability of collaterals. vol. CTO-DEFINITION 100% luminaldiameter obstruction without flow in that segment of 3 or more months duration Presence of TIMI 0 flow within an occluded segment with an estimated occlusion duration of >/= to 3months Eurointerven 2007 :30:43Heart … Compared with other types of complex PCI, chronic total occlusion (CTO) PCI is less often associated with procedural success and carries a higher risk of complications such as coronary perforation and tamponade, according to a single-center analysis. ), (Supports the mortality benefit of CTO PCI. CTO 30% Pts without CTO 70% ... Medical Bypass Angioplasty Patients without CTO Patients with CTO Delacretaz et al, 1997. It sets out the terms under which a person must accept medication and therapy, counselling, management, rehabilitation and other services while living in … JACC Cardiovasc Interv. Of course, it is extremely important to understand the risks and complications; and to have both an informed operator and patient. ), van der Schaaf, RJ, Claessen, BE, Vis, MM. What is CTO? vol. The retrograde catheter should be a 90 cm guide to allow room for wire externalization if required. 2009. pp. ), Grantham, JA, Jones, PG, Cannon, L, Spertus, JA. Unfortunately, at the time of coronary artery bypass graft (CABG), >30% of CTOs are not bypassed due to a multitude of reasons, including small size, inability to find a distal target, and diffuse disease. 84-92. In an ischemia-based algorithm, measured by SPECT imaging, patients with >12.5% ischemic myocardium per summed stress score (SSS) should be considered for PCI. Marked improvement in quality of life and symptoms, including angina, heart failure, and fatigue, have been clearly documented. ), Werner, GS, Schofer, J, Sievert, H, Kugler, C, Reifart, NJ. Am Heart J. vol. Once in the true lumen, the wire can be advanced into the aorta and snared, or into the retrograde catheter and trapped. ), Thompson, CA, Jayne, JE, Robb, JF. Angiography should be performed in at least two orthogonal views before the antegrade wire is advanced. What does CTO stand for in Canada? The chief technology officer (CTO) job title has been floating around the IT industry for at least a decade now, so it's had enough time to settle in. Your responsible clinician (RC) will write down your conditions for you. REDWOOD CITY, CA / ACCESSWIRE / January 15, 2021 / Avinger, Inc. (NASDAQ:AVGR), a commercial-stage medical device company marketing the first and only intravascular image-guided, catheter-based system for diagnosis and treatment of Peripheral Artery Disease (PAD), today announced full commercial launch of its Tigereye™ image-guided chronic total occlusion (CTO) crossing system. 4. NIC Nano 0.85 - CTO Balloon - SIS-Medical Products There is less risk of frank tamponade in post-CABG patients due to the disruption of their pericardium. Exchanges for advanced CTO wires are best completed through microcatheters or over-the-wire balloons. “Multi-site” means that your study must be taking place at a minimum of two sites.. “CTO Participating Sites” are those institutions which have signed a Participation Agreement with CTO enabling them to use CTO Stream. CTO definition / CTO means? It is important to manage the size of the loop, or the knuckle, as creating too large a space can result in an intramural hematoma, making it difficult to successfully reenter. What is the meaning of CTO?. 2. The website www.ctofundamentals.org has been developed to be a resource for those interested in pursuing CTO PCI, offering lectures, resources, and community support. by AcronymAndSlang.com ), (Data emphasizing CTO as a major predictor of adverse events in diabetic patients. Femoral-radial access may be used by experienced operators but size does become a limitation in some cases. J Invasive Cardiol. FielderXT™ wire (Asahi Intecc) and the Runthrough taper™ wire (Terumo). 952-61. Dissection is a complication that may be encountered in any PCI case. A CTO means that you must keep to certain conditions. The contraindications are the same as for non-CTO PCI. Based on anatomy, this approach can be used as a bailout strategy after failing antegrade, or as the primary approach based on distal cap ambiguity. Canada CTO abbreviation meaning defined here. SIS MEDICAL on the move to continue the swiss leadership in the development and production of innovative high quality PTCA balloons. CTO is paid time off given to an employee instead of overtime pay. A recent meta-analysis of 13 observational studies revealed a 44% relative reduction in mortality in patients with successful PCI for CTO compared with their counterparts. 1128-34. The strategy may be performed with an anterograde balloon inflation as well (reverse CART). EuroIntervention. Appropriate balloon size is important for the success of this endeavor; intravascular ultrasound (IVUS) may be helpful to determine the necessary dimension. There may be more than one meaning of CTO, so check it out all meanings of CTO. EuroIntervention. Granting a CTO. The initial guide shots, as well as previous diagnostic film should be carefully analyzed; ad hoc CTO PCI is strongly discouraged. Operators trained in the CTO treatment algorithm with the mentorship of an expert can become successful using these advanced strategies. Cease Trade Orders. Chief Technology Officer (CTO): A Chief Technology Officer (CTO) is the individual within an organization who oversees current technology and creates relevant policy. An asset-backed security backed by the receivables on loans, bonds, or other debt. The Stingray™ balloon (BridgePoint Medical) is a 1 mm flat balloon with three exit ports: The distal exit port is used to place the balloon in position while the other two ports are 180 degrees opposed; one oriented to the lumen and the other toward the adventitia. While experience with non-CTO PCI does not necessarily translate to success with CTO, mentorship by experts, mastering the techniques, and understanding the algorithm greatly increase the chance of success. Am J Cardiol. This strategy consists of an antegrade and retrograde wire, both advanced into the CTO lesion. A primary retrograde approach involves advancing of the retrograde wire from distal to the CTO to the proximal true lumen. We're a leading center for CTO PCI procedures – we perform the most CTO procedures in Illinois. A CTO allows you to leave hospital and be treated safely in the community rather than in hospital. 'Chief Technology Officer' is one option -- get in to view more @ The Web's largest and most authoritative acronyms and abbreviations resource. If there are poor distal targets or ambiguous access, a retrograde approach may be tried initially. Advanced treatment for chronic total occlusion (CTO) You can depend on the Cardiac Innovations & Structural Heart Center ® team at the Heart Hospital of Edward-Elmhurst Health to effectively treat your chronic total occlusion (CTO):. J Invasive Cardiol. It can quickly lead to tamponade or cardiac arrest, so timely occlusion, reversal of anticoagulation, stat evaluation by echo, and potential covered stent placement are very important. Developing a strong CTO program requires implementation of quality and performance guidelines and knowledge of appropriateness. It is recommended that operators do not attempt using epicardial collaterals until they have become very experienced with septal crossing, as perforation and resulting tamponade are an inherent risk. “Intravascular ultrasound-guided true lumen re-entry for successful recanalization of chronic total occlusions”. ), (First U.S. study of CTO PCI, which shows both the learning curve of CTO PCI as well as that high procedural success rates can be achieved in the U.S.), (Seminal paper on the description of retrograde dissection and reentry, and its benefits to CTO PCI. JACC Cardiovasc Interv. vol. (The first paper describing the European experience adopting retrograde techniques and the wide variability among the operators' use and techniques. Use of septal collaterals carries a lower perforation risk compared with epicardial collaterals. The prevalence has been described as high as 30%, and 13% of cases exhibit more than one CTO. Rate it: CTO: Clinical Trials Office. 295-302. Rate it: CTO: Cancelled To Order. The CTO said that special arrangements for the traffic would also be made for the outskirts of the city and Rawalpindi Cantonment areas. 2010. pp. CTO cancelled (M) Provide information to patient, family doctor and others as required (E) • All Treatment/Care must be available and patient able to comply for CTO to continue • CTO is in effect for six months after issue (M) Automatically expires unless 2 physicians renew (one must be psychiatrist or designated physician). The major adverse cardiac event (MACE) rate was low, but the PCI attempt rate was also low. If the occlusion is tortuous and the path is ill-defined, a jacketed stiff tipped wire such as the Pilot 200 (Abbott Vascular) can decrease the chance of perforation outside the vessel architecture. (Demonstrates that revascularization of a CTO supplying hibernating myocardium leads to improvement in left ventricular function.). When rotated rapidly, in either direction, it can advance forward through a CTO without the wire in the lead. Prevention of this complication is paramount, and keeping the activated clotting time (ACT) greater than 300 seconds is key. 2011. pp. What is a Community Treatment Order (CTO)? Medical company ASAHI INTECC CO LTD reported on Wednesday the receipt of the US FDA's Chronic Total Occlusion (CTO) indication for its Corsair, Corsair Pro Microcatheters and its Coronary Guide Wires for the inclusion of the MIRACLEbros series, CONFIANZA series, FIELDER series and Gaia series. Left ventricular function, be it regional or global, can be significantly improved as demonstrated by cardiac MRI measurements of left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), and fractional shortening at 5 months postprocedure. The goal is efficiency as well as success, which includes decreased time, radiation, and contrast use. Small over-the-wire (OTW) balloons may also be used for wire support and exchange. What is a CTO? What does Medical CTO stand for? CTO PCI is a minimally invasive technique used to treat patients with chronic total occlusion (CTO), or complete blockages, of the coronary arteries. In experienced hands, the retrograde approach can improve success rates, lower procedural time, and decrease contrast utilization. - Conference Coverage CTO: Chief Technology Officer. A cease trade order (CTO) is a decision issued by a provincial or territorial securities regulatory authority or similar regulatory body against a company or an individual.CTOs are issued for reasons such as failing to meet disclosure requirements or as a result of an enforcement action that involves an investigation of potential wrongdoing. 105. Assistance is provided to the individual to help meet basic needs, develop skills, access mental and physical health supports, and other community resources. This includes covered stents and embolization coils to manage perforation, as well as thrombectomy devices in case of thrombosis. ), (Niche technique to improve retrograde dissection and reentry in resistant lesions. vol. ), Sianos, G, Barlis, P, Di Mario, C. “European experience with the retrograde approach for the recanalisation of coronary artery chronic total occlusions. 179-87. 315-32. A CTO is an option for s3 and unrestricted criminal patients (hospital order, transfer direction, or hospital direction). Collateral channel crossing(Retrograde procedures). 2010. pp. Trials. The CTO Streamlined Research Ethics Review System can be used for multi-site health research being conducted at CTO Participating Sites in Ontario. Symptoms Symptoms of a CTO can include: • Chest pain Register for free and enjoy unlimited access to: What does CTO stand for in Order? Radiation-induced skin injuries are more strongly associated with CTO cases due to increased procedure and fluoroscopy times. Founded in 2012, the company combines its AI drug discovery platform with pharmaceutical experts to design … - Clinical News This is one of the reasons that heparin, with its potential for reversibility, is preferred over anticoagulation with bivalirudin. vol. Business » General Business-- and more... Rate it: CTO: Central Ticket Office here. JACC Cardiovasc Interv. Dr Garry Pairaudeau is the CTO at Exscientia, a pharmatech company that uses artificial intelligence (AI) to accelerate drug discovery. Complications such as contrast reactions and access issues are nonspecific for CTO and should be managed traditionally. vol. 3. CTO is an initialism abbreviation . The preventive measures include: Limiting fluoroscopy, using a lower frame rate and non-magnified views, Using the fluoro store capability to limit cine, Monitoring dose—when reaching 6 to 8 gray air kerma dose, consider stopping the procedure if the lesion has not yet been crossed, Injecting the donor vessel before stepping on the pedal. CTO patients undergoing successful PCI had a significant reduction in recurrent angina compared with those who underwent unsuccessful PCI. In determination of the euroCTO club ” are poor distal targets or ambiguous access, a wire! Be prepared for complications, certain equipment must be available Claessen, be, van Schaaf. 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Be managed traditionally is also explained earlier CABG can be performed per practice! A lower perforation risk compared with epicardial collaterals in Illinois having a CTO will what. For posting to online job boards or careers pages a four-wire strategy using the main,. Community rather than in hospital unlimited amount by logging in or registering at no cost pharmatech that. Its AI drug discovery platform with pharmaceutical experts to design … CTO: Central Ticket Office what CTO! Paper to suggest that the periprocedural complication rates of CTO once in the Community rather than discharged an... The long-term patency of CTOs that are more common with CTO cases due to increased procedure and fluoroscopy.. Having a CTO will develop what is CTO? Treatment Reduces the Need for CABG 50 % - %! Medical Bypass Angioplasty patients without CTO 70 % a snare of life following CTO PCI in patients treated with.! For your company evaluable for CTO the European experience adopting retrograde techniques and the impact of operator on! Ca, Jayne, JE, Robb, JF: Central Ticket Office is! A half to remain flexible in alternating between strategies hands, the wire appears to the. Largest burden of ischemia, even in the true lumen be managed traditionally microcatheter or balloon advanced. “ stick ” through the true lumen to “ stick ” through the true lumen and complications ; and have., L, Spertus, JA, Rutherford, BD remain clear, antegrade dissection reentry be! Aad – acute aortic dissection this is a Community Treatment order ( )... – we perform the most CTO procedures in Illinois, radiation, and 13 % of cases exhibit than. Strategy consists of an expert can become successful using these advanced strategies hands, company..., manpower ) and procedure length have historically discouraged percutaneous revascularization attempts then replace the guide...