TY - JOUR
T1 - Procedural characteristics and outcomes following chronic total occlusion coronary intervention
T2 - pooled analysis from 5 registries
AU - Rathore, Sudhir
AU - Khanra, Dibbendu
AU - Galassi, Alfredo R.
AU - Boukhris, Marouane
AU - Tsuchikane, Etsuo
AU - Dens, Joseph
AU - Mashayekhi, Kambis
AU - Grantham, J. Aaron
AU - Brilakis, Emmanouil S.
AU - Karmpaliotis, Dimitri
AU - Werner, Gerald S.
N1 - Funding Information:
M Brilakis reports consulting/speaker honoraria from Abbott Vascular, American Heart Association (associate editor Circulation), Amgen, Asahi Intecc, Biotronik, Boston Scientific, Cardiovascular Innovations Foundation (Board of Directors), ControlRad, CSI, Elsevier, GE Healthcare, InfraRedx, Medtronic, Siemens, and Teleflex; research support from Regeneron; owner, Hippocrates LLC; shareholder: MHI Ventures, Cleerly Health.
Publisher Copyright:
© 2021 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2021
Y1 - 2021
N2 - Background: Recent improvements in clinical skills, technology, and hardware have resulted in improved success rates with chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We performed a study level pooled analysis from the five largest registries of percutaneous coronary intervention (PCI) of CTO. Research design and methods: We conducted pooled analysis of 9500 patients in registries and data on procedural characteristics, technical success, and MACCE was collected. Results: A total of 9500 patients were included in the analysis. Mean age was 65.4 years with previous CABG in 24.8%, reattempt procedure in 24.8% and mean JCTO score was 2.2. Final wiring strategy in hybrid algorithm-based registries was AWE in 40.8–58%, Retrograde in 24–35%, ADR in 16–25% and in Expert JCTO and EURO CTO was AWE in 72–75% and retrograde in 25–28%. Technical success was achieved in 87.8%. In hospital MACCE was 2.5% (95% CI: 1.8– 3.4%), mortality 0.44% (95% CI: 0.23–0.84%), stroke 0.2% (95% CI: 0.1–0.3%); myocardial infraction 1.6% (95% CI: 1.1–2.2%); and cardiac tamponade 0.8% (95% CI: 0.5 to 1.3%). Conclusion: CTO PCI is currently performed with high technical success rates and low complication rates in experienced hands utilizing various techniques.
AB - Background: Recent improvements in clinical skills, technology, and hardware have resulted in improved success rates with chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We performed a study level pooled analysis from the five largest registries of percutaneous coronary intervention (PCI) of CTO. Research design and methods: We conducted pooled analysis of 9500 patients in registries and data on procedural characteristics, technical success, and MACCE was collected. Results: A total of 9500 patients were included in the analysis. Mean age was 65.4 years with previous CABG in 24.8%, reattempt procedure in 24.8% and mean JCTO score was 2.2. Final wiring strategy in hybrid algorithm-based registries was AWE in 40.8–58%, Retrograde in 24–35%, ADR in 16–25% and in Expert JCTO and EURO CTO was AWE in 72–75% and retrograde in 25–28%. Technical success was achieved in 87.8%. In hospital MACCE was 2.5% (95% CI: 1.8– 3.4%), mortality 0.44% (95% CI: 0.23–0.84%), stroke 0.2% (95% CI: 0.1–0.3%); myocardial infraction 1.6% (95% CI: 1.1–2.2%); and cardiac tamponade 0.8% (95% CI: 0.5 to 1.3%). Conclusion: CTO PCI is currently performed with high technical success rates and low complication rates in experienced hands utilizing various techniques.
KW - Coronary chronic total occlusion
KW - MACCE
KW - cardiac tamponade
KW - outcomes
KW - procedural success
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U2 - 10.1080/14779072.2021.1997590
DO - 10.1080/14779072.2021.1997590
M3 - Article
C2 - 34714700
AN - SCOPUS:85119138852
SN - 1477-9072
VL - 19
SP - 929
EP - 938
JO - Expert Review of Cardiovascular Therapy
JF - Expert Review of Cardiovascular Therapy
IS - 10
ER -