@article{54001bef16be463b93f1b3241372cd9e,
title = "In-hospital outcomes of chronic total occlusion percutaneous coronary interventions in patients with prior coronary artery bypass graft surgery insights from an international multicenter chronic total occlusion registry",
abstract = "BACKGROUND: We examined the procedural outcomes of chronic total occlusions (CTO) percutaneous coronary interventions in patients with prior coronary artery bypass graft surgery (CABG). METHODS AND RESULTS: We compared the clinical, angiographic characteristics and outcomes of 3486 CTO interventions performed in patients with (n=1101) and without (n=2317) prior CABG at 21 centers. Prior CABG patients (32% of total cohort) were older (67±9 versus 63±10 years; P<0.001) and had more comorbidities and lower left ventricular ejection fraction (50% [40-58] versus 55% [45-60]; P<0.001). The CTO target vessel in prior CABG patients was the right coronary artery (56%), circumflex (26%), and left anterior descending artery (17%). The mean J-CTO (2.9±1.2 versus 2.2±1.3; P<0.001) and PROGRESS-CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention; 1.5±1.1 versus 1.2±1.0; P<0.001) score was higher in prior CABG patients. Retrograde (53% versus 30%, P<0.001) and antegrade dissection reentry (35% versus 28%; P<0.001) techniques were used more frequently in prior CABG patients. Prior CABG patients had lower technical (84% versus 89%; P<0.001) and procedural (82% versus 87%, P<0.001) success, but similar incidence of in-hospital major complications (3.1% versus 2.5%; P=0.287). In-hospital mortality (1% versus 0.4%; P=0.016) and coronary perforation (7.1% versus 3.1%; P<0.001) occurred more frequently in prior CABG patients, however, CABG patients had a lower incidence of pericardial tamponade (0.1% versus 1.0%; P=0.002) and pericardiocentesis (0% versus 1.3%; P<0.001). CONCLUSIONS: In a large multicenter CTO percutaneous coronary interventions registry, prior CABG patients had lower success rate but similar overall risk for complications, although mortality was higher and the incidence of tamponade was lower.",
keywords = "Chronic total occlusion, Coronary bypass graft surgery, Outcomes, Percutaneous coronary intervention, Perforation",
author = "Peter Tajti and Dimitri Karmpaliotis and Khaldoon Alaswad and Jaffer, {Farouc A.} and Yeh, {Robert W.} and Mitul Patel and Ehtisham Mahmud and Choi, {James W.} and {Nicholas Burke}, M. and Doing, {Anthony H.} and Phil Dattilo and Catalin Toma and {Conrad Smith}, {A. J.} and Barry Uretsky and Elizabeth Holper and Srinivas Potluri and {Michael Wyman}, R. and Kandzari, {David E.} and Santiago Garcia and Oleg Krestyaninov and Dmitrii Khelimskii and Michalis Koutouzis and Ioannis Tsiafoutis and Wissam Jaber and Habib Samady and Moses, {Jeffrey W.} and Lembo, {Nicholas J.} and Manish Parikh and Kirtane, {Ajay J.} and Ali, {Ziad A.} and Darshan Doshi and Iosif Xenogiannis and Stanberry, {Larissa I.} and Rangan, {Bavana V.} and Imre Ungi and Subhash Banerjee and Brilakis, {Emmanouil S.}",
note = "Funding Information: This study data were collected and managed using Research Electronic Data Capture (REDCap) electronic data capture tools hosted at the Minneapolis Heart Institute Foundation, Minneapolis, MN. REDCap is a secure, web-based application designed to support data capture for research studies, providing: (1) an intuitive interface for validated data entry; (2) audit trails for tracking data manipulation and export procedures; (3) automated export procedures for seamless data downloads to common statistical packages; and (4) procedures for importing data from external sources. The Progress chronic total occlusion (CTO) registry has received support from the Abbott Northwestern Hospital Foundation, Minneapolis, MN. Funding Information: Dr Karmpaliotis has received speaker honoraria from Abbott Vascular, Boston Scientific, Medtronic, and Vascular Solutions. Dr Alaswad received consulting fees from Terumo and Boston Scientific; and is a consultant for no financial, Abbott Laboratories. Dr Jaffer is a consultant for Abbott Vascular, Boston Scientific, Siemens. Research grant from Canon, Siemens and National Institutes of Health. Dr Yeh has received Career Development Award (1K23HL118138) from the National Heart, Lung, and Blood Institute. Dr Patel is a member of the speakers{\textquoteright} bureau for Astra Zeneca. Dr Mahmud received has consulting fees from Medtronic and Corindus; speaker{\textquoteright}s fees from Medtronic, Corindus, and Abbott Vascular; educational program fees from Abbott Vascular; and clinical events committee fees from St. Jude. Dr Burke received consulting and speaker honoraria from Abbott Vascular and Boston Scientific. Dr Wyman has received Honoraria/consulting/speaking fees from Boston Scientific, Abbott Vascular, and Asahi. Dr Kandzari has received research/grant support and consulting honoraria from Boston Scientific and Medtronic Cardiovascular, and research/grant support from Abbott. Dr Garcia has received consulting fees from Medtronic. Dr Moses is a consultant to Boston Scientific and Abiomed. Dr Lembois a member of speaker bureau and is a member of Medtronic; advisory board Abbott Vascular and Medtronic. Dr Parikh is a member of speaker bureau for Abbot Vascular, Medtronic, CSI, BSC, Trireme; advisory boards for Medtronic, Abbott Vascular, Philips. Dr Kirtane has received institutional research grants to Columbia University from Boston Scientific, Medtronic, Abbott Vascular, Abiomed, St Jude Medical, Vascular Dynamics, Glaxo SmithKline, and Eli Lilly. Dr Ali has received consultant fees/honoraria from St Jude Medical, and AstraZeneca Pharmaceuticals; ownership interest/partnership/principal in Shockwave Medical and VitaBx Inc; and research grants from Medtronic and St Jude Medical. B V. Rangan has received research grants from InfraReDx, Inc, and the Spectranetics Corporation. Dr Banerjee has received research grants from Gilead and the Medicines Company; and received consultant/speaker honoraria from Covidien and Medtronic; ownership in MDCARE Global (spouse); intellectual property in HygeiaTel. Dr Brilakis has received consulting/speaker honoraria from Abbott Vascular, Boston Scientific, American Heart Association (associate editor Circulation), Boston Scientific, Cardiovascular Innovations Foundation (Board of Directors), CSI, Elsevier, GE Healthcare, InfraRedx, and Medtronic; research support from Siemens, and Regeneron. Shareholder: MHI Ventures; Board of Trustees: Society of Cardiovascular Angiography and Interventions. The other authors report no conflicts. Publisher Copyright: {\textcopyright} 2019 American Heart Association, Inc.",
year = "2019",
doi = "10.1161/CIRCINTERVENTIONS.118.007338",
language = "English (US)",
volume = "12",
journal = "Circulation: Cardiovascular Interventions",
issn = "1941-7640",
publisher = "Lippincott Williams and Wilkins",
number = "3",
}