Frequency and Outcomes of Ad Hoc Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From the PROGRESS-CTO Registry

被引：0

作者：

Simsek, Bahadir ^{[1
,2
]}

Rempakos, Athanasios ^{[1
,2
]}

Kostantinis, Spyridon ^{[1
,2
]}

Karacsonyi, Judit ^{[1
,2
]}

Rinfret, Stephane

Jaber, Wissam ^{[3
]}

Nicholson, William ^{[3
]}

Gorgulu, Sevket ^{[4
]}

Alaswad, Khaldoon ^{[5
]}

Khatri, Jaikirshan ^{[6
]}

Poommipanit, Paul ^{[7
]}

Aygul, Nazif ^{[8
]}

Krestyaninov, Oleg ^{[9
]}

Khelimskii, Dmitrii ^{[9
]}

Uretsky, Barry ^{[10
,11
]}

Goktekin, Omer ^{[12
]}

Dattilo, Philip ^{[13
]}

Potluri, Srinivasa ^{[14
]}

Al-Azizi, Karim ^{[14
]}

Mastrodemos, Olga C. ^{[1
,2
]}

Rangan, Bavana, V ^{[1
,2
]}

Allana, Salman S. ^{[1
,2
]}

Sandoval, Yader ^{[1
,2
]}

Burke, M. Nicholas ^{[1
,2
]}

Brilakis, Emmanouil S. ^{[1
,2
,15
]}

机构：

[1] Minneapolis Heart Inst, Minneapolis, MN USA

[2] Minneapolis Heart Inst Fdn, Minneapolis, MN USA

[3] Emory Univ, Div Cardiol, Atlanta, GA USA

[4] Biruni Univ, Sch Med, Dept Cardiol, Kocaeli, Turkiye

[5] Henry Ford Hosp, Div Cardiol, Detroit, MI USA

[6] Cleveland Clin Fdn, Cleveland, OH USA

[7] Case Western Reserve Univ, Univ Hosp, Cleveland, OH USA

[8] Selcuk Univ, Dept Cardiol, Konya, Turkiye

[9] Minist Hlth Russian Federat, Dept Invas Cardiol, Meshalkin Natl Med Res Ctr, Novosibirsk, Russia

[10] Cent Arkansas Vet Hlth Syst, Dept Cardiol, Little Rock, AR USA

[11] Univ Arkansas Med Sci, Little Rock, AR USA

[12] Mem Bahcelievler Hosp, Dept Cardiol, Istanbul, Turkiye

[13] UC Hlth Med Ctr Rockies, Loveland, CO USA

[14] Baylor Scott & White Hlth, Dept Cardiol, Dallas, TX USA

[15] Minneapolis Heart Inst Fdn, Minneapolis Heart Inst, Ctr Complex Coronary Intervent, Ctr Coronary Artery Dis, 920 E 28th St 300, Minneapolis, MN 55407 USA

来源：

JOURNAL OF INVASIVE CARDIOLOGY | 2023年 / 35卷 / 07期

关键词：

ad hoc; planning; chronic total occlusion; percutaneous coronary intervention; PRINCIPLES; SUCCESS;

D O I：

暂无

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND. Although discouraged, ad hoc chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is occasionally performed. METHODS. We examined the clinical, angiographic characteristics, and procedural outcomes of patients who underwent ad hoc CTO PCI in the Prospective Global Registry for the Study of CTO Intervention (PROGRESS-CTO, NCT02061436). RESULTS. Of the 10,998 patients included in the registry, 899 (8.2%) underwent ad hoc CTO PCI. The incidence of ad hoc CTO PCI decreased from 18% in 2016 to 3% in 2022. Ad hoc CTO PCI patients had a lower prevalence of comorbidities and less complex angiographic characteristics demonstrated by lower J-CTO score (1.9 +/- 1.2 vs 2.4 +/- 1.3, P<.001). In these patients, PROGRESS-CTO major adverse cardiovascular events (MACE) (1.9 +/- 1.4 vs 2.5 +/- 1.7), mortality (1.2 +/- 1.0 vs 1.6 +/- 1.1), and perforation (1.5 +/- 1.2 +/- 2.2 vs 1.5) scores were lower (P<.001). Technical success was similar between the groups (86%). MACE were lower in the ad hoc CTO PCI group (.8% vs 2.0%, P=.009). Ad hoc CTO PCI was not associated with MACE after adjusting for potential confounders, odds ratio: .69 (95% confidence interval, .30-1.57). In patients with higher J-CTO scores, planned CTO PCI was associated with higher technical success (P<.001). CONCLUSION. Approximately 8% of CTO PCI procedures are performed ad hoc, usually in less complex lesions and patients with lower complication risk. While ad hoc CTO PCI might be appropriate for carefully selected cases, a staged approach is recommended for most CTO PCI.

引用

页数：9

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