Left main chronic total occlusion percutaneous coronary intervention: A case series

Iosif Xenogiannis; Dimitri Karmpaliotis; Khaldoon Alaswad; Mir B. Basir; Robert W. Yeh; Hector Tamez; Mitul Patel; Ehtisham Mahmud; James W. Choi; M. Nicholas Burke; Anthony H. Doing; Phil Dattilo; Jaikirshan J. Khatri; Abdul M. Sheikh; Bilal A. Malik; Mary E. Greene; Nidal Abi Rafeh; Assaad Maalouf; Fadi Abou Jaoudeh; Jeffrey W. Moses; Nicholas J. Lembo; Manish Parikh; Ajay J. Kirtane; Ziad A. Ali; Fotis Gkargkoulas; Juan Russo; Emad Hakemi; Peter Tajti; Allison B. Hall; Evangelia Vemmou; Ilias Nikolakopoulos; Bavana Venkata Rangan; Shuaib Abdullah; Subhash Banerjee; Emmanouil S. Brilakis

Left main chronic total occlusion percutaneous coronary intervention: A case series

Iosif Xenogiannis, Dimitri Karmpaliotis, Khaldoon Alaswad, Mir B. Basir, Robert W. Yeh, Hector Tamez, Mitul Patel, Ehtisham Mahmud, James W. Choi, M. Nicholas Burke, Anthony H. Doing, Phil Dattilo, Jaikirshan J. Khatri, Abdul M. Sheikh, Bilal A. Malik, Mary E. Greene, Nidal Abi Rafeh, Assaad Maalouf, Fadi Abou Jaoudeh, Jeffrey W. MosesNicholas J. Lembo, Manish Parikh, Ajay J. Kirtane, Ziad A. Ali, Fotis Gkargkoulas, Juan Russo, Emad Hakemi, Peter Tajti, Allison B. Hall, Evangelia Vemmou, Ilias Nikolakopoulos, Bavana Venkata Rangan, Shuaib Abdullah, Subhash Banerjee, Emmanouil S. Brilakis

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

Background. Left main coronary artery (LMCA) chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. Methods. We reviewed 4436 CTO-PCIs performed in 4340 patients between 2012 and 2018 at 25 sites. LMCA-CTO-PCI was performed in 20 cases (0.45%). We examined the clinical and angiographic characteristics and procedural outcomes of these cases. Results. Mean patient age was 68 ± 11 years and 65% were men. Most patients (85%) had undergone prior coronary artery bypass graft surgery and had a protected left main. Mean J-CTO score was 2.7 ± 1.3, mean PROGRESS-CTO score was 1.3 ± 1.1, and mean PROGRESS-CTO Complications score was 3.8 ± 1.9. Antegrade-wire escalation was the most common successful crossing strategy (50%), followed by retrograde crossing (30%) and antegrade dissection/re-entry (10%). Technical and procedural success rates were both 85%. One patient with failed LMCA-CTO-PCI had periprocedural myocardial infarction. Median procedure time was 178 minutes (interquartile range [IQR], 123-250 minutes), median contrast volume was 190 mL (IQR, 133-339 mL), and patient air kerma radiation dose was 2.6 Gray (IQR, 1.3-3.9 Gray). Conclusions. LMCA-CTO-PCI is infrequent, is performed mostly in patients with prior coronary artery bypass graft surgery, and is associated with good procedural outcomes.

Original language	English (US)
Pages (from-to)	E220-E225
Journal	Journal of Invasive Cardiology
Volume	31
Issue number	7
State	Published - 2019

Keywords

Chronic total occlusion
Left main coronary artery
Percutaneous coronary intervention

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging
Cardiology and Cardiovascular Medicine

Cite this

Xenogiannis, I., Karmpaliotis, D., Alaswad, K., Basir, M. B., Yeh, R. W., Tamez, H., Patel, M., Mahmud, E., Choi, J. W., Burke, M. N., Doing, A. H., Dattilo, P., Khatri, J. J., Sheikh, A. M., Malik, B. A., Greene, M. E., Rafeh, N. A., Maalouf, A., Jaoudeh, F. A., ... Brilakis, E. S. (2019). Left main chronic total occlusion percutaneous coronary intervention: A case series. Journal of Invasive Cardiology, 31(7), E220-E225.

Xenogiannis, I, Karmpaliotis, D, Alaswad, K, Basir, MB, Yeh, RW, Tamez, H, Patel, M, Mahmud, E, Choi, JW, Burke, MN, Doing, AH, Dattilo, P, Khatri, JJ, Sheikh, AM, Malik, BA, Greene, ME, Rafeh, NA, Maalouf, A, Jaoudeh, FA, Moses, JW, Lembo, NJ, Parikh, M, Kirtane, AJ, Ali, ZA, Gkargkoulas, F, Russo, J, Hakemi, E, Tajti, P, Hall, AB, Vemmou, E, Nikolakopoulos, I, Rangan, BV, Abdullah, S, Banerjee, S & Brilakis, ES 2019, 'Left main chronic total occlusion percutaneous coronary intervention: A case series', Journal of Invasive Cardiology, vol. 31, no. 7, pp. E220-E225.

@article{7d087317285d4a2e996a9b42431b5a46,

title = "Left main chronic total occlusion percutaneous coronary intervention: A case series",

abstract = "Background. Left main coronary artery (LMCA) chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. Methods. We reviewed 4436 CTO-PCIs performed in 4340 patients between 2012 and 2018 at 25 sites. LMCA-CTO-PCI was performed in 20 cases (0.45%). We examined the clinical and angiographic characteristics and procedural outcomes of these cases. Results. Mean patient age was 68 ± 11 years and 65% were men. Most patients (85%) had undergone prior coronary artery bypass graft surgery and had a protected left main. Mean J-CTO score was 2.7 ± 1.3, mean PROGRESS-CTO score was 1.3 ± 1.1, and mean PROGRESS-CTO Complications score was 3.8 ± 1.9. Antegrade-wire escalation was the most common successful crossing strategy (50%), followed by retrograde crossing (30%) and antegrade dissection/re-entry (10%). Technical and procedural success rates were both 85%. One patient with failed LMCA-CTO-PCI had periprocedural myocardial infarction. Median procedure time was 178 minutes (interquartile range [IQR], 123-250 minutes), median contrast volume was 190 mL (IQR, 133-339 mL), and patient air kerma radiation dose was 2.6 Gray (IQR, 1.3-3.9 Gray). Conclusions. LMCA-CTO-PCI is infrequent, is performed mostly in patients with prior coronary artery bypass graft surgery, and is associated with good procedural outcomes.",

keywords = "Chronic total occlusion, Left main coronary artery, Percutaneous coronary intervention",

author = "Iosif Xenogiannis and Dimitri Karmpaliotis and Khaldoon Alaswad and Basir, {Mir B.} and Yeh, {Robert W.} and Hector Tamez and Mitul Patel and Ehtisham Mahmud and Choi, {James W.} and Burke, {M. Nicholas} and Doing, {Anthony H.} and Phil Dattilo and Khatri, {Jaikirshan J.} and Sheikh, {Abdul M.} and Malik, {Bilal A.} and Greene, {Mary E.} and Rafeh, {Nidal Abi} and Assaad Maalouf and Jaoudeh, {Fadi Abou} and Moses, {Jeffrey W.} and Lembo, {Nicholas J.} and Manish Parikh and Kirtane, {Ajay J.} and Ali, {Ziad A.} and Fotis Gkargkoulas and Juan Russo and Emad Hakemi and Peter Tajti and Hall, {Allison B.} and Evangelia Vemmou and Ilias Nikolakopoulos and Rangan, {Bavana Venkata} and Shuaib Abdullah and Subhash Banerjee and Brilakis, {Emmanouil S.}",

note = "Funding Information: The PROGRESS-CTO registry has received support from the Abbott Northwestern Hospital Foundation, Minneapolis, Minnesota. Publisher Copyright: {\textcopyright} 2019 HMP Communications. All rights reserved.",

year = "2019",

language = "English (US)",

volume = "31",

pages = "E220--E225",

journal = "Journal of Invasive Cardiology",

issn = "1042-3931",

publisher = "HMP Communications",

number = "7",

}

TY - JOUR

T1 - Left main chronic total occlusion percutaneous coronary intervention

T2 - A case series

AU - Xenogiannis, Iosif

AU - Karmpaliotis, Dimitri

AU - Alaswad, Khaldoon

AU - Basir, Mir B.

AU - Yeh, Robert W.

AU - Tamez, Hector

AU - Patel, Mitul

AU - Mahmud, Ehtisham

AU - Choi, James W.

AU - Burke, M. Nicholas

AU - Doing, Anthony H.

AU - Dattilo, Phil

AU - Khatri, Jaikirshan J.

AU - Sheikh, Abdul M.

AU - Malik, Bilal A.

AU - Greene, Mary E.

AU - Rafeh, Nidal Abi

AU - Maalouf, Assaad

AU - Jaoudeh, Fadi Abou

AU - Moses, Jeffrey W.

AU - Lembo, Nicholas J.

AU - Parikh, Manish

AU - Kirtane, Ajay J.

AU - Ali, Ziad A.

AU - Gkargkoulas, Fotis

AU - Russo, Juan

AU - Hakemi, Emad

AU - Tajti, Peter

AU - Hall, Allison B.

AU - Vemmou, Evangelia

AU - Nikolakopoulos, Ilias

AU - Rangan, Bavana Venkata

AU - Abdullah, Shuaib

AU - Banerjee, Subhash

AU - Brilakis, Emmanouil S.

N1 - Funding Information: The PROGRESS-CTO registry has received support from the Abbott Northwestern Hospital Foundation, Minneapolis, Minnesota. Publisher Copyright: © 2019 HMP Communications. All rights reserved.

PY - 2019

Y1 - 2019

N2 - Background. Left main coronary artery (LMCA) chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. Methods. We reviewed 4436 CTO-PCIs performed in 4340 patients between 2012 and 2018 at 25 sites. LMCA-CTO-PCI was performed in 20 cases (0.45%). We examined the clinical and angiographic characteristics and procedural outcomes of these cases. Results. Mean patient age was 68 ± 11 years and 65% were men. Most patients (85%) had undergone prior coronary artery bypass graft surgery and had a protected left main. Mean J-CTO score was 2.7 ± 1.3, mean PROGRESS-CTO score was 1.3 ± 1.1, and mean PROGRESS-CTO Complications score was 3.8 ± 1.9. Antegrade-wire escalation was the most common successful crossing strategy (50%), followed by retrograde crossing (30%) and antegrade dissection/re-entry (10%). Technical and procedural success rates were both 85%. One patient with failed LMCA-CTO-PCI had periprocedural myocardial infarction. Median procedure time was 178 minutes (interquartile range [IQR], 123-250 minutes), median contrast volume was 190 mL (IQR, 133-339 mL), and patient air kerma radiation dose was 2.6 Gray (IQR, 1.3-3.9 Gray). Conclusions. LMCA-CTO-PCI is infrequent, is performed mostly in patients with prior coronary artery bypass graft surgery, and is associated with good procedural outcomes.

AB - Background. Left main coronary artery (LMCA) chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. Methods. We reviewed 4436 CTO-PCIs performed in 4340 patients between 2012 and 2018 at 25 sites. LMCA-CTO-PCI was performed in 20 cases (0.45%). We examined the clinical and angiographic characteristics and procedural outcomes of these cases. Results. Mean patient age was 68 ± 11 years and 65% were men. Most patients (85%) had undergone prior coronary artery bypass graft surgery and had a protected left main. Mean J-CTO score was 2.7 ± 1.3, mean PROGRESS-CTO score was 1.3 ± 1.1, and mean PROGRESS-CTO Complications score was 3.8 ± 1.9. Antegrade-wire escalation was the most common successful crossing strategy (50%), followed by retrograde crossing (30%) and antegrade dissection/re-entry (10%). Technical and procedural success rates were both 85%. One patient with failed LMCA-CTO-PCI had periprocedural myocardial infarction. Median procedure time was 178 minutes (interquartile range [IQR], 123-250 minutes), median contrast volume was 190 mL (IQR, 133-339 mL), and patient air kerma radiation dose was 2.6 Gray (IQR, 1.3-3.9 Gray). Conclusions. LMCA-CTO-PCI is infrequent, is performed mostly in patients with prior coronary artery bypass graft surgery, and is associated with good procedural outcomes.

KW - Chronic total occlusion

KW - Left main coronary artery

KW - Percutaneous coronary intervention

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M3 - Article

C2 - 31257217

AN - SCOPUS:85068977206

SN - 1042-3931

VL - 31

SP - E220-E225

JO - Journal of Invasive Cardiology

JF - Journal of Invasive Cardiology

IS - 7

ER -

Left main chronic total occlusion percutaneous coronary intervention: A case series

Abstract

Keywords

ASJC Scopus subject areas

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