TY - JOUR
T1 - Contemporary In-Hospital Outcomes of Chronic Total Occlusion Percutaneous Coronary Interventions
T2 - Insights from the MENATA (Middle East, North Africa, Turkey, and Asia) Chapter of the PROGRESS-CTO Registry
AU - Gorgulu, Sevket
AU - Kostantinis, Spyridon
AU - ElGuindy, Ahmed M.
AU - Abi Rafeh, Nidal
AU - Simsek, Bahadir
AU - Rempakos, Athanasios
AU - Karacsonyi, Judit
AU - Kalay, Nihat
AU - Samir, Ahmad
AU - Jaoudeh, Fadi Abou
AU - Maalouf, Assaad
AU - Soylu, Korhan
AU - Yildirim, Ufuk
AU - Tigen, Mustafa Kursat
AU - Cincin, Altug
AU - Kalyanasundaram, Arun
AU - Aygul, Nazif
AU - Altunkeser, Bulent Behlul
AU - El Sayed, Ali
AU - Sadek, Yasser
AU - Shelton, Charlie
AU - Jbara, Kassem
AU - Vemmou, Evangelia
AU - Nikolakopoulos, Ilias
AU - Mastrodemos, Olga C.
AU - Rangan, Bavana V.
AU - Allana, Salman S.
AU - Sandoval, Yader
AU - Burke, M. Nicholas
AU - Brilakis, Emmanouil S.
AU - Goktekin, Omer
N1 - Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023/11/1
Y1 - 2023/11/1
N2 - Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has been rapidly evolving in different parts of the world. We examined the clinical and angiographic characteristics and procedural outcomes of 1,079 consecutive CTO PCIs performed in 1,063 patients at 10 centers in the Middle East, North Africa, Turkey, and Asia regions between 2018 and 2022. The mean age was 61 ± 10 years and 82% of the patients were men. The prevalence of diabetes (49%) and previous PCI (50%) was high. The most common target vessel was the right coronary artery (51%), followed by the left anterior descending artery (33%) and the circumflex artery (15%). The mean Japanese CTO score was 2.1 ± 1.2 and mean PROGRESS-CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) score was 1.2 ± 1.0. The technical and procedural success rates were high (91% and 90%, respectively) with a low incidence (1.6%) of in-hospital major adverse cardiac events. The incidence of perforation was 4.6% (n = 50): guidewire exit was the most common mechanism of perforation (48%) and 14 patients required pericardiocentesis (28%). Antegrade wire escalation was the most common crossing strategy used (91%), followed by retrograde approach (24%) and antegrade dissection and re-entry (12%). Median contrast volume, air kerma radiation dose, and fluoroscopy time were 300 (200 to 400) ml, 3.7 (2.0 to 6.3) Gy, and 40 (25 to 65) minutes, respectively. In conclusion, high success and acceptable complication rates are currently achieved at experienced centers in the Middle East, North Africa, Turkey, and Asia regions using a combination of crossing strategies.
AB - Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has been rapidly evolving in different parts of the world. We examined the clinical and angiographic characteristics and procedural outcomes of 1,079 consecutive CTO PCIs performed in 1,063 patients at 10 centers in the Middle East, North Africa, Turkey, and Asia regions between 2018 and 2022. The mean age was 61 ± 10 years and 82% of the patients were men. The prevalence of diabetes (49%) and previous PCI (50%) was high. The most common target vessel was the right coronary artery (51%), followed by the left anterior descending artery (33%) and the circumflex artery (15%). The mean Japanese CTO score was 2.1 ± 1.2 and mean PROGRESS-CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) score was 1.2 ± 1.0. The technical and procedural success rates were high (91% and 90%, respectively) with a low incidence (1.6%) of in-hospital major adverse cardiac events. The incidence of perforation was 4.6% (n = 50): guidewire exit was the most common mechanism of perforation (48%) and 14 patients required pericardiocentesis (28%). Antegrade wire escalation was the most common crossing strategy used (91%), followed by retrograde approach (24%) and antegrade dissection and re-entry (12%). Median contrast volume, air kerma radiation dose, and fluoroscopy time were 300 (200 to 400) ml, 3.7 (2.0 to 6.3) Gy, and 40 (25 to 65) minutes, respectively. In conclusion, high success and acceptable complication rates are currently achieved at experienced centers in the Middle East, North Africa, Turkey, and Asia regions using a combination of crossing strategies.
KW - chronic total occlusion
KW - outcomes
KW - percutaneous coronary intervention
UR - http://www.scopus.com/inward/record.url?scp=85171425890&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85171425890&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2023.08.103
DO - 10.1016/j.amjcard.2023.08.103
M3 - Article
C2 - 37717475
AN - SCOPUS:85171425890
SN - 0002-9149
VL - 206
SP - 221
EP - 229
JO - American Journal of Cardiology
JF - American Journal of Cardiology
ER -