Effect of Lesion Age on Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Contemporary US Multicenter Registry

Autor: Aris Karatasakis, Craig A. Thompson, Manish Parikh, Robert W. Yeh, Aya Alame, Farouc A. Jaffer, Judit Karacsonyi, Ajay Kirtane, Catalin Toma, Ziad A. Ali, Emmanouil S. Brilakis, Phuong Khanh J Nguyen-Trong, Khaldoon Alaswad, Jeffrey W. Moses, Mitul Patel, J. Aaron Grantham, Anthony Doing, R. Michael Wyman, John Bahadorani, Subhash Banerjee, Nicholas Lembo, Pratik Kalsaria, David E. Kandzari, Barbara A. Danek, Dimitri Karmpaliotis, William Lombardi, Santiago Garcia
Rok vydání: 2016
Předmět:
Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
030204 cardiovascular system & hematology
Coronary Angiography
Severity of Illness Index
Article
Lesion
03 medical and health sciences
Percutaneous Coronary Intervention
Postoperative Complications
0302 clinical medicine
Risk Factors
Interquartile range
Outcome Assessment
Health Care
Severity of illness
medicine
Humans
cardiovascular diseases
030212 general & internal medicine
Vascular Calcification
Aged
Retrospective Studies
business.industry
Incidence
Percutaneous coronary intervention
Retrospective cohort study
Middle Aged
Plaque
Atherosclerotic
United States
Surgery
Coronary Occlusion
Coronary occlusion
Chronic Disease
Conventional PCI
Female
Risk Adjustment
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Mace
Zdroj: Canadian Journal of Cardiology. 32:1433-1439
ISSN: 0828-282X
Popis: Background We sought to determine the effect of lesion age on procedural techniques and outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Methods We examined the characteristics and outcomes of 394 CTO PCIs with data on lesion age, performed between 2012 and 2016 at 11 experienced US centres. Results Mean patient age was 66 ± 10 years and 85.6% of the patients were men. Overall technical and procedural success rates were 90.1% and 87.5%, respectively. A major adverse cardiovascular event (MACE) occurred in 16 patients (4.1%). Mean and median lesion ages were 43 ± 62 months and 12 months (interquartile range, 3-64 months), respectively. Patients were stratified into tertiles according to lesion age (3-5, 5-36.3, and > 36.3 months). Older lesion age was associated with older patient age (68 ± 8 vs 65 ± 10 vs 64 ± 11 years; P = 0.009), previous coronary artery bypass grafting (62% vs 42% vs 30%; P P = 0.001). Older lesions more often required use of the retrograde approach and antegrade dissection/re-entry for successful lesion crossing. There was no difference in technical (87.8% vs 89.6% vs 93.0%; P = 0.37) or procedural (86.3% vs 87.4% vs 89.0%; P = 0.80) success, or the incidence of MACE (3.1% vs 3.0% vs 6.3%; P = 0.31) for older vs younger occlusions. Conclusions Older CTO lesions exhibit angiographic complexity and more frequently necessitate the retrograde approach or antegrade dissection/re-entry. Older CTOs can be recanalized with high technical and procedural success and acceptable MACE rates. Lesion age appears unlikely to be a significant determinant of CTO PCI success.
Databáze: OpenAIRE
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