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Retrograde Recanalization of Chronic Total Occlusions in Europe: Procedural, In-Hospital, and Long-Term Outcomes From the Multicenter ERCTO Registry

Authors :
Galassi, AR
Sianos, G
Werner, GS
Escaned, J
Tomasello, SD
Boukhris, M
Castaing, M
Buttner, JH
Bufe, A
Kalnins, A
Spratt, JC
Garbo, R
Hildick-Smith, D
Elhadad, S
Gagnor, A
Lauer, B
Bryniarski, L
Christiansen, EH
Thuesen, L
Meyer-Gessner, M
Goktekin, O
Carlino, M
Louvard, Y
Lefevre, T
Lismanis, A
Gelev, VL
Serra, A
Marza, F
Di Mario, C
Reifart, N
Galassi A.R.
Sianos G.
Werner G.S.
Escaned J.
Tomasello S.D.
Boukhris M.
Castaing M.
Buttner J.H.
Bufe A.
Kalnins A.
Spratt J.C.
Garbo R.
Hildick-Smith D.
Elhadad S.
Gagnor A.
Lauer B.
Bryniarski L.
Christiansen E.H.
Thuesen L.
Meyer-Gessner M.
Goktekin O.
Carlino M.
Louvard Y.
Lefevre T.
Lismanis A.
Gelev V.L.
Serra A.
Marza F.
Di Mario C.
Reifart N.
Source :
Galassi, A R, Sianos, G, Werner, G S, Escaned, J, Tomasello, S D, Boukhris, M, Castaing, M, Büttner, J H, Bufe, A, Kalnins, A, Spratt, J C, Garbo, R, Hildick-Smith, D, Elhadad, S, Gagnor, A, Lauer, B, Bryniarski, L, Christiansen, E H, Thuesen, L, Meyer-Geßner, M, Goktekin, O, Carlino, M, Louvard, Y, Lefèvre, T, Lismanis, A, Gelev, V L, Serra, A, Marzà, F, Di Mario, C, Reifart, N & Euro CTO Club 2015, ' Retrograde Recanalization of Chronic Total Occlusions in Europe : Procedural, In-Hospital, and Long-Term Outcomes From the Multicenter ERCTO Registry ', Journal of the American College of Cardiology, vol. 65, no. 22, pp. 2388-400 . https://doi.org/10.1016/j.jacc.2015.03.566, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau, instname
Publication Year :
2015

Abstract

BACKGROUND A retrograde approach improves the success rate of percutaneous coronary interventions (PCIs) for chronic total occlusions (CTOs). OBJECTIVES The authors describe the European experience with and outcomes of retrograde PCI revascularization for coronary CTOs. METHODS Follow-up data were collected from 1,395 patients with 1,582 CTO lesions enrolled between January 2008 and December 2012 for retrograde CTO PCI at 44 European centers. Major adverse cardiac and cerebrovascular events were defined as the composite of cardiac death, myocardial infarction, stroke, and further revascularization. RESULTS The mean patient age was 62.0 +/- 10.4 years; 88.5% were men. Procedural and clinical success rates were 75.3% and 71.2%, respectively. The mean clinical follow-up duration was 24.7 +/- 15.0 months. Compared with patients with failed retrograde PCI, successfully revascularized patients showed lower rates of cardiac death (0.6% vs. 4.3%, respectively; p < 0.001), myocardial infarction (2.3% vs. 5.4%, respectively; p = 0.001), further revascularization (8.6% vs. 23.6%, respectively; p < 0.001), and major adverse cardiac and cerebrovascular events (8.7% vs. 23.9%, respectively; p < 0.001). Female sex (hazard ratio [HR]: 2.06; 95% confidence interval [CI]: 1.33 to 3.18; p = 0.001), prior PCI (HR: 1.73; 95% CI: 1.16 to 2.60; p = 0.011), low left ventricular ejection fraction (HR: 2.43; 95% CI: 1.22 to 4.83; p = 0.011), J-CTO (Multicenter CTO Registry in Japan) score >= 3 (HR: 2.08; 95% CI: 1.32 to 3.27; p = 0.002), and procedural failure (HR: 2.48; 95% CI: 1.72 to 3.57; p < 0.001) were independent predictors of major adverse cardiac and cerebrovascular events at long-term follow-up. CONCLUSIONS The number of retrograde procedures in Europe has increased, with high percents of success, low rates of major complications, and good long-term outcomes. (C) 2015 by the American College of Cardiology Foundation.

Details

ISSN :
15583597 and 07351097
Volume :
65
Issue :
22
Database :
OpenAIRE
Journal :
Journal of the American College of Cardiology
Accession number :
edsair.pmid.dedup....c2451a91092fee15d0c5e85597172734
Full Text :
https://doi.org/10.1016/j.jacc.2015.03.566