TY - JOUR
T1 - The Hybrid Approach to Chronic Total Occlusion Percutaneous Coronary Intervention
T2 - Update From the PROGRESS CTO Registry
AU - Tajti, Peter
AU - Karmpaliotis, Dimitri
AU - Alaswad, Khaldoon
AU - Jaffer, Farouc A.
AU - Yeh, Robert W.
AU - Patel, Mitul
AU - Mahmud, Ehtisham
AU - Choi, James W.
AU - Burke, M. Nicholas
AU - Doing, Anthony H.
AU - Dattilo, Phil
AU - Toma, Catalin
AU - Smith, A. J.Conrad
AU - Uretsky, Barry
AU - Holper, Elizabeth
AU - Wyman, R. Michael
AU - Kandzari, David E.
AU - Garcia, Santiago
AU - Krestyaninov, Oleg
AU - Khelimskii, Dmitrii
AU - Koutouzis, Michalis
AU - Tsiafoutis, Ioannis
AU - Moses, Jeffrey W.
AU - Lembo, Nicholas J.
AU - Parikh, Manish
AU - Kirtane, Ajay J.
AU - Ali, Ziad A.
AU - Doshi, Darshan
AU - Rangan, Bavana V.
AU - Ungi, Imre
AU - Banerjee, Subhash
AU - Brilakis, Emmanouil S.
N1 - Publisher Copyright:
© 2018 American College of Cardiology Foundation
PY - 2018/7/23
Y1 - 2018/7/23
N2 - Objectives: The aim of this study was to determine the techniques and outcomes of hybrid chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in a diverse group of patients and operators on 2 continents. Background: CTO PCI has been evolving with constant improvement of equipment and techniques. Methods: Contemporary outcomes of CTO PCI were examined by analyzing the clinical, angiographic, and procedural characteristics of 3,122 CTO interventions performed in 3,055 patients at 20 centers in the United States, Europe, and Russia. Results: The mean age was 65 ± 10 years, and 85% of the patients were men, with high prevalence of diabetes (43%), prior myocardial infarction (46%), prior coronary artery bypass graft surgery (33%), and prior PCI (65%). The CTO target vessels were the right coronary artery (55%), left anterior descending coronary artery (24%), and left circumflex coronary artery (20%). The mean J-CTO (Multicenter Chronic Total Occlusion Registry of Japan) and PROGRESS CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) scores were 2.4 ± 1.3 and 1.3 ± 1.0, respectively. The overall technical and procedural success rate was 87% and 85%, respectively, and the rate of in-hospital major complications was 3.0%. The final successful crossing strategy was antegrade wire escalation in 52.0%, retrograde in 27.1%, and antegrade dissection re-entry in 20.9%; >1 crossing strategy was required in 40.9%. Median contrast volume, air kerma radiation dose, and procedure and fluoroscopy time were 270 ml (interquartile range: 200 to 360 ml), 2.9 Gy (interquartile range: 1.7 to 4.7 Gy), 123 min (interquartile range: 81 to 188 min) and 47 min (interquartile range: 29 to 77 min), respectively. Conclusions: CTO PCI is currently being performed with high success and acceptable complication rates among various experienced centers in the United States, Europe, and Russia.
AB - Objectives: The aim of this study was to determine the techniques and outcomes of hybrid chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in a diverse group of patients and operators on 2 continents. Background: CTO PCI has been evolving with constant improvement of equipment and techniques. Methods: Contemporary outcomes of CTO PCI were examined by analyzing the clinical, angiographic, and procedural characteristics of 3,122 CTO interventions performed in 3,055 patients at 20 centers in the United States, Europe, and Russia. Results: The mean age was 65 ± 10 years, and 85% of the patients were men, with high prevalence of diabetes (43%), prior myocardial infarction (46%), prior coronary artery bypass graft surgery (33%), and prior PCI (65%). The CTO target vessels were the right coronary artery (55%), left anterior descending coronary artery (24%), and left circumflex coronary artery (20%). The mean J-CTO (Multicenter Chronic Total Occlusion Registry of Japan) and PROGRESS CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) scores were 2.4 ± 1.3 and 1.3 ± 1.0, respectively. The overall technical and procedural success rate was 87% and 85%, respectively, and the rate of in-hospital major complications was 3.0%. The final successful crossing strategy was antegrade wire escalation in 52.0%, retrograde in 27.1%, and antegrade dissection re-entry in 20.9%; >1 crossing strategy was required in 40.9%. Median contrast volume, air kerma radiation dose, and procedure and fluoroscopy time were 270 ml (interquartile range: 200 to 360 ml), 2.9 Gy (interquartile range: 1.7 to 4.7 Gy), 123 min (interquartile range: 81 to 188 min) and 47 min (interquartile range: 29 to 77 min), respectively. Conclusions: CTO PCI is currently being performed with high success and acceptable complication rates among various experienced centers in the United States, Europe, and Russia.
KW - chronic total occlusion
KW - outcomes
KW - percutaneous coronary intervention
KW - techniques
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U2 - 10.1016/j.jcin.2018.02.036
DO - 10.1016/j.jcin.2018.02.036
M3 - Article
C2 - 29706508
AN - SCOPUS:85045892862
SN - 1936-8798
VL - 11
SP - 1325
EP - 1335
JO - JACC: Cardiovascular Interventions
JF - JACC: Cardiovascular Interventions
IS - 14
ER -