Details

Autor(en) / Beteiligte

• Sandoval, Yader
• Tajti, Peter
• Karatasakis, Aris
• Burke, M Nicholas
• Danek, Barbara A
• Karmpaliotis, Dimitri
• Alaswad, Khaldoon
• Jaffer, Farouc A
• Yeh, Robert W
• Patel, Mitul
• Mahmud, Ehtisham
• Krestyaninov, Oleg
• Khelimskii, Dmitrii
• Choi, James W
• Doing, Anthony H
• Toma, Catalin
• Wyman, R Michael
• Uretsky, Barry
• Garcia, Santiago
• Koutouzis, Michalis
• Tsiafoutis, Ioannis
• Holper, Elizabeth
• Moses, Jeffrey W
• Lembo, Nicholas J
• Parikh, Manish
• Kirtane, Ajay J
• Ali, Ziad A
• Doshi, Darshan
• Kandzari, David E
• Karacsonyi, Judit
• Rangan, Bavana V
• Thompson, Craig
• Banerjee, Subhash
• Brilakis, Emmanouil S

Titel

Frequency and Outcomes of Ad Hoc Versus Planned Chronic Total Occlusion Percutaneous Coronary Intervention: Multicenter Experience

Ist Teil von

• The Journal of invasive cardiology, 2019-05, Vol.31 (5), p.133-139

Ort / Verlag

United States

Erscheinungsjahr

2019

Quelle

MEDLINE

Beschreibungen/Notizen

• For patients needing coronary chronic total occlusion (CTO) percutaneous coronary intervention (PCI), a planned, staged intervention has been recommended by experts. Ad hoc CTO-PCI, however, occurs in practice. Observational, contemporary, multicenter, international registry. Our goals were to determine the frequency, characteristics, procedural techniques, and outcomes of patients who underwent ad hoc vs planned CTO-PCI. Among 2282 patients who underwent CTO-PCI between 2012 and 2017, 318 (14%) were ad hoc. Patients undergoing ad hoc CTO-PCI had lower J-CTO, PROGRESS CTO, and PROGRESS Complications scores. Antegrade-wire escalation was used more often in ad hoc PCI (96% vs 81%; P<.001), whereas antegrade-dissection re-entry (22% vs 32%) and retrograde approaches (14% vs 38%) were more common in planned PCI (P<.001). There was no difference in ad hoc vs planned PCI in technical (85% vs 86%) and procedural success (84% vs 84%). In-hospital major adverse cardiac events (MACE) were more common in patients who underwent planned procedures (0.6% vs 2.9%; P=.02). Multivariable analyses showed that ad hoc CTO-PCI was not associated with technical success or MACE. Ad hoc CTO-PCI occurs more commonly in less complex lesions and is associated with similarly high success rates as planned CTO-PCI in lower J-CTO score lesions, suggesting that ad hoc CTO-PCI may be an acceptable option for experienced hybrid operators in carefully selected cases. Complex cases, as quantified by the J-CTO score, have a higher in-hospital MACE rate and should preferably be performed following proper planning and preparation.