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Retrograde Recanalization of Chronic Total Occlusions in Europe: Procedural, In-Hospital, and Long-Term Outcomes From the Multicenter ERCTO Registry
- 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.
- Subjects :
- Male
Time Factors
Incidence
Middle Aged
Coronary Angiography
Settore MED/11 - Malattie Dell'Apparato Cardiovascolare
Hospitals
Europe
Electrocardiography
Percutaneous Coronary Intervention
Postoperative Complications
Treatment Outcome
Coronary Occlusion
chronic total occlusions
J-CTO score
Chronic Disease
Humans
retrograde PCI revascularization
Female
Hospital Mortality
Prospective Studies
Registries
chronic total occlusion
Follow-Up Studies
Subjects
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