In-Hospital Outcomes After Recanalization of Ostial Chronic Total Occlusions

Autor: Michael Behnes, Christian Blockhaus, Alexander Bufe, Ibrahim Akin, Kambis Mashayekhi, Julian Kuervers, Jan Gesenberg, Jan-Erik Guelker
Rok vydání: 2020
Předmět:
Zdroj: Cardiovascular Revascularization Medicine. 21:661-665
ISSN: 1553-8389
DOI: 10.1016/j.carrev.2019.09.019
Popis: Percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) still remains a major challenge in interventional cardiology. Recanalization of ostial lesions is challenging and complex. This present study aims to evaluate the outcome of patients with ostial and non-ostial CTO-PCI with regard to acute, in-hospital outcome.Between 2012 and 2018 we included 600 patients. Ostial lesions (OL) were defined as a coronary arterial stenosis within 3 mm of the vessel origin. Antegrade and retrograde CTO-PCI techniques were used and a composite safety endpoint comprising in-hospital death, vascular complications, cardiac tamponade, stroke and acute myocardial infarction.The majority of the patients were male (82.3%) and the mean age was 62.1 years (±10.3 years). The right coronary artery (RCA) was the most frequent target vessel in 58.5%, followed by the left circumflex artery (LCX) (15.4%) and the left anterior descending artery (LAD) (26.2%). The success (p = .439) and complication rates (p = .169) were independent of the target vessel. We determined that examination and fluoroscopy time were longer in patients with OL (120.7 min vs. 99.0 min, p .001 and 44.9 min vs. 34.5 min, p .001) and that in this group of patients the retrograde approach was used more frequent (38.8% vs. 18.2%, p .001). Overall success rates were lower in OL than compared to NOL (74.6% vs. 86.5%, p = .016).Our retrospective study suggests that recanalization of ostial CTO lesions is associated with reduced PCI success rates as well as long examination and high fluoroscopy times.
Databáze: OpenAIRE
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