Usefulness of Atherectomy in Chronic Total Occlusion Interventions (from the PROGRESS-CTO Registry)
| Autor: | Mitul Patel, Srinivas Potluri, Robert W. Yeh, Iosif Xenogiannis, Wissam Jaber, Santiago Garcia, Jeffrey W. Moses, Habib Samady, Elizabeth M. Holper, Peter Tajti, Catalin Toma, Ioannis Tsiafoutis, Ziad A. Ali, Emmanouil S. Brilakis, Ehtisham Mahmud, Nicholas Lembo, Phil Dattilo, Dimitri Karmpaliotis, Bavana V. Rangan, Dmitrii Khelimskii, Anthony Doing, Taral Patel, Ajay J. Kirtane, Khaldoon Alaswad, David E. Kandzari, Manish Parikh, Darshan Doshi, A.J. Conrad Smith, Farouc A. Jaffer, Subhash Banerjee, Brian K. Jefferson, Oleg Krestyaninov, R. Michael Wyman, M. Nicholas Burke, Barry F. Uretsky, Shuaib M Abdullah, Jaikirshan Khatri, James W. Choi, Michalis Koutouzis |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Atherectomy Time Factors medicine.medical_treatment 030204 cardiovascular system & hematology Rotational atherectomy Coronary Angiography Total occlusion Orbital atherectomy 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine medicine Humans Registries 030212 general & internal medicine Aged Retrospective Studies business.industry Follow up studies Percutaneous coronary intervention Retrospective cohort study Middle Aged Coronary Vessels Treatment Outcome Coronary Occlusion Chronic Disease Conventional PCI Cardiology Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The American Journal of Cardiology. 123:1422-1428 |
| ISSN: | 0002-9149 |
| Popis: | There is limited data on the use of atherectomy during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We compared the clinical and procedural characteristics and outcomes of CTO PCIs performed with or without atherectomy in a contemporary multicenter CTO PCI registry. Between 2012 and 2018, 3,607 CTO PCIs were performed at 21 participating centers. Atherectomy was used in 117 (3.2%) cases: rotational atherectomy in 105 cases, orbital atherectomy in 8, and both in 4 cases. Patients in whom atherectomy was used, were older (68 ± 8 vs 64 ± 10 years, p0.0001) and had higher Japan-chronic total occlusion score (3.0 ± 1.2 vs 2.4 ± 1.3, p0.0001). CTO PCI cases in which atherectomy was used had similar technical (91% vs 87%, p = 0.240) and procedural (90% vs 85%, p = 0.159) success and in-hospital major adverse cardiac event (4% vs 3%, p = 0.382) rates. However, atherectomy cases were associated with higher rates of donor vessel injury (4% vs 1%, p = 0.031), tamponade requiring pericardiocentesis (2.6% vs 0.4%, p = 0.012) and more often required use of a left ventricular assist device (9% vs 5%, p = 0.031). Atherectomy cases were associated with longer procedural duration (196 [141, 247] vs 119 [76, 180] minutes, p0.0001), and higher patient air kerma radiation dose (3.6 [2.5, 5.6] vs 2.8 [1.6, 4.7] Gray, p = 0.001). In conclusion, atherectomy is currently performed in approximately 3% of CTO PCI cases and is associated with similar technical and procedural success and overall major adverse cardiac event rates, but higher risk for donor vessel injury and tamponade. |
| Databáze: | OpenAIRE |
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