Impact of lesion length on the outcomes of chronic total occlusion percutaneous coronary intervention: Insights from the PROGRESS-CTO registry

被引：4

作者：

Rempakos, Athanasios ^{[1
,2
]}

Simsek, Bahadir ^{[1
,2
]}

Kostantinis, Spyridon ^{[1
,2
]}

Karacsonyi, Judit ^{[1
,2
]}

Choi, James W. ^{[3
]}

Poommipanit, Paul ^{[4
]}

Khatri, Jaikirshan J. ^{[5
]}

Jaber, Wissam ^{[6
]}

Rinfret, Stephane ^{[6
]}

Nicholson, William ^{[6
]}

Gorgulu, Sevket ^{[7
]}

Jaffer, Farouc A. ^{[8
,9
]}

Chandwaney, Raj ^{[10
]}

Koutouzis, Michael ^{[11
]}

Tsiafoutis, Ioannis ^{[11
]}

Alaswad, Khaldoon ^{[12
]}

Krestyaninov, Oleg ^{[13
]}

Khelimskii, Dmitrii ^{[13
]}

Karmpaliotis, Dimitrios ^{[14
]}

Uretsky, Barry F. ^{[15
]}

Patel, Mitul P. ^{[16
]}

Mahmud, Ehtisham ^{[16
]}

Potluri, Srinivasa ^{[17
]}

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

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

Allana, Salman ^{[1
,2
]}

Sandoval, Yader ^{[1
,2
]}

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

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

机构：

[1] Abbott NW Hosp, Minneapolis Heart Inst, Ctr Coronary Artery Dis, Minneapolis, MN USA

[2] Abbott NW Hosp, Minneapolis Heart Inst Fdn, Minneapolis, MN USA

[3] Texas Hlth Presbyterian Hosp, Dept Cardiol, Dallas, TX USA

[4] Case Western Reserve Univ, Univ Hosp, Sect Cardiol, Cleveland, OH USA

[5] Cleveland Clin, Dept Cardiovasc Med, Cleveland, OH USA

[6] Emory Univ Hosp Midtown, Div Cardiol, Atlanta, GA USA

[7] Biruni Univ, Med Sch, Dept Cardiol, Istanbul, Turkiye

[8] Massachusetts Gen Hosp, Cardiovasc Res Ctr, Boston, MA USA

[9] Massachusetts Gen Hosp, Cardiol Div, Boston, MA USA

[10] Oklahoma Heart Inst, Dept Invas Cardiol, Tulsa, OK USA

[11] Red Cross Hosp Athens, Dept Cardiol, Athens, TX, Greece

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

[13] Meshalkin Novosibirsk Res Inst, Dept Invas Cardiol, Novosibirsk, Russia

[14] Morristown Med Ctr, Gagnon Cardiovasc Inst, Morristown, NJ USA

[15] Cent Arkansas Vet Healthcare Syst, Dept Cardiol, Little Rock, AR USA

[16] UCSD, Med Ctr, Div Cardiovasc Med, La Jolla, CA USA

[17] Heart Hosp Baylor Plano, Dept Cardiac Catheterizat, Plano, TX USA

来源：

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS | 2023年 / 101卷 / 04期

关键词：

chronic total occlusion; lesion length; occlusion length; percutaneous coronary intervention; SCORING SYSTEM; CONTEMPORARY; PREDICT;

D O I：

10.1002/ccd.30581

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BackgroundThe impact of occlusion length on the procedural techniques and outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. MethodsWe examined the clinical and angiographic characteristics and procedural outcomes of 10,335 CTO PCIs at 42 US and non-US centers between 2012 and 2022. The cohort was divided into two groups based on lesion length (>= 20 mm vs. <20 mm). ResultsLong lesions were present in 7208 (70%) patients. Comorbidities were more common in patients with long CTOs. Compared with short lesions, long lesions had higher J-CTO score (2.8 +/- 1.1 vs. 1.3 +/- 1; p < 0.001) and retrograde wiring was more often the initial (15.5% vs. 4.0%; p < 0.001) and successful (22.8% vs. 8.2%; p < 0.001) crossing strategy. Long lesions were more likely to require longer procedure (123 vs. 91 min; p < 0.001) and fluoroscopy (47.1 vs. 32.2 min; p < 0.001) time, larger contrast volume (218 vs. 200 mL; p < 0.001) and higher air kerma radiation dose (2.4 vs. 1.7 Gy; p < 0.001). After adjusting for potential confounders, long lesions were associated with lower technical success (odds ratio [OR]: 0.91 per 10 mm increase; 95% confidence interval [CI]: 0.88, 0.94) and higher major adverse cardiovascular events (MACE) (OR: 1.08 per 10 mm increase; 95% CI: 1.02, 1.15). ConclusionsCTO PCI of long occlusions is independently associated with lower rates of technical success and higher rates of in-hospital MACE.

引用

页码：747 / 755

页数：9

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