1. Impact of concomitant treatment of non-chronic total occlusion lesions at the time of chronic total occlusion intervention.
- Author
-
Xenogiannis I, Karmpaliotis D, Alaswad K, Jaffer FA, Yeh RW, Patel M, Mahmud E, Choi JW, Burke MN, Doing AH, Dattilo P, Toma C, Uretsky B, Krestyaninov O, Khelimskii D, Holper E, Potluri S, Wyman RM, Kandzari DE, Garcia S, Koutouzis M, Tsiafoutis I, Khatri JJ, Jaber W, Samady H, Jefferson BK, Patel T, Moses JW, Lembo NJ, Parikh M, Kirtane AJ, Ali ZA, Gkargkoulas F, Tajti P, Hall AB, Rangan BV, Abdullah S, Banerjee S, and Brilakis ES
- Subjects
- Acute Disease, Age Factors, Chronic Disease, Coronary Angiography methods, Female, Humans, Male, Middle Aged, Operative Time, Outcome Assessment, Health Care, Radiation Dosage, Registries statistics & numerical data, Risk Assessment, Risk Factors, Acute Coronary Syndrome diagnosis, Acute Coronary Syndrome etiology, Coronary Occlusion diagnosis, Coronary Occlusion physiopathology, Coronary Occlusion surgery, Coronary Vessels diagnostic imaging, Coronary Vessels pathology, Coronary Vessels physiopathology, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention methods, Postoperative Complications diagnosis, Postoperative Complications etiology
- Abstract
Background: During chronic total occlusion (CTO) percutaneous coronary intervention (PCI), sometimes non-CTO lesions are also treated., Methods: We compared the clinical and procedural characteristics and outcomes of CTO PCIs with and without concomitant treatment of a non-CTO lesion in a contemporary multicenter CTO registry., Results: Of the 3598 CTO PCIs performed at 21 centers between 2012 and 2018, 814 (23%) also included PCI of at least one non-CTO lesion. Patients in whom non-CTO lesions were treated were older (65 ± 10 vs. 64 ± 10 years, p = 0.03), more likely to present with an acute coronary syndrome (32% vs. 23%, p < 0.01), and less likely to undergo PCI of a right coronary artery (RCA) CTO (46% vs. 58%, p < 0.01). The most common non-CTO lesion location was the left anterior descending artery (31%), followed by the circumflex (29%) and the RCA (25%).Combined non-CTO and CTO-PCI procedures had similar technical (88% vs. 87%, p = 0.33) and procedural (85% vs. 85%, p = 0.74) success and major in-hospital complication rates (3.4% vs. 2.7%, p = 0.23), but had longer procedure duration (131 [88, 201] vs. 117 [75, 179] minutes, p < 0.01), higher patient air kerma radiation dose (3.0 [1.9, 4.8] vs. 2.8 [1.5, 4.6] Gray, p < 0.01) and larger contrast volume (300 [220, 380] vs. 250 [180, 350] ml, p < 0.01)., Conclusions: Combined CTO PCI with PCI of non-CTO lesions is associated with similar success and major in-hospital complication rates compared with cases in which only CTOs were treated, but requires longer procedure duration and higher radiation dose and contrast volume., (Copyright © 2019 Elsevier B.V. All rights reserved.)
- Published
- 2020
- Full Text
- View/download PDF