Procedural, Functional and Prognostic Outcomes Following Recanalization of Coronary Chronic Total Occlusions. Results of the Iberian Registry

被引：13

作者：

Amat-Santos, Ignacio J. ^{[1
]}

Martin-Yuste, Victoria ^{[2
]}

Antonio Fernandez-Diaz, Jose ^{[3
]}

Martin-Moreiras, Javier ^{[4
]}

Caballero-Borrego, Juan ^{[5
]}

Salinas, Pablo ^{[6
]}

Ojeda, Soledad ^{[7
]}

Rivero, Fernando ^{[8
]}

Nunez Villota, Julio ^{[9
]}

Mohandes, Mohsen ^{[10
]}

Dubois, Daniela ^{[11
]}

Bosa Ojeda, Francisco ^{[12
]}

Rumiz, Eva ^{[13
]}

de la Torre Hernandez, Jose M. ^{[14
]}

Jimenez-Mazuecos, Jesus ^{[15
]}

Lacunza, Javier ^{[16
]}

Tejedor, Paula ^{[17
]}

Gomez, Itziar ^{[1
]}

Goncalves-Ramirez, Luis R. ^{[1
]}

Rojas, Paol ^{[1
]}

Sabate, Manel ^{[2
]}

Goicolea, Javier ^{[3
]}

Diego Nieto, Alejandro ^{[4
]}

Jimenez-Fernandez, Miriam ^{[5
]}

Escaned, Javier ^{[6
]}

Gonzalo, Nieves ^{[6
]}

Pardo, Laura ^{[7
]}

Cuesta, Javier ^{[8
]}

Minana, Gema ^{[9
]}

Sanchis, Juan ^{[9
]}

Rojas, Sergio ^{[10
]}

Millan, Raul ^{[11
]}

Vaquerizo, Beatriz ^{[11
]}

Rodriguez, Sara ^{[12
]}

Lee, Dae-Hyun ^{[14
]}

Morales, Francisco J. ^{[18
]}

Gutierrez, Alejandro ^{[19
]}

Lopez, Maria ^{[20
]}

Maristany, Jaume ^{[21
]}

Rondan, Juan ^{[22
]}

Galeote, Guillermo ^{[23
]}

Kabbanni, Zuheir ^{[24
]}

Rodriguez, Sergio ^{[25
]}

Teruel, Luis ^{[26
]}

Sadaba, Mario ^{[27
]}

Jurado, Alfonso ^{[28
]}

Mainar, Vicente ^{[29
]}

Sanchez-Rubio, Juan ^{[30
]}

Vinhas, Hugo ^{[31
]}

Fernandes, Renato ^{[32
]}

机构：

[1] Hosp Clin Univ, Ctr Invest Biomed Red Enfermedades Cardiovasc CIB, Serv Cardiol, Valladolid, Spain

[2] Hosp Clin Barcelona, Serv Cardiol, Barcelona, Spain

[3] Hosp Puerta Hierro, Serv Cardiol, Madrid, Spain

[4] Hosp Clin Univ Salamanca, Serv Cardiol, Salamanca, Spain

[5] Hosp Campus Salud & Virgen Nieves, Serv Cardiol, Granada, Spain

[6] Hosp Clin San Carlos, Serv Cardiol, Madrid, Spain

[7] Hosp Reina Sofia Cordoba, Serv Cardiol, Cordoba, Spain

[8] Hosp La Princesa, Serv Cardiol, Madrid, Spain

[9] Univ Valencia, Ctr Invest Biomed Red Enfermedades Cardiovasc CIB, Hosp Clin Univ, INCLIVA,Serv Cardiol, Valencia, Spain

[10] Hosp Tarragona, Serv Cardiol, Tarragona, Spain

[11] Hosp del Mar, Serv Cardiol, Barcelona, Spain

[12] Hosp Tenerife, Serv Cardiol, Santa Cruz De Tenerife, Spain

[13] Hosp Gen Valencia, Serv Cardiol, Valencia, Spain

[14] Hosp Marques Valdecilla, Serv Cardiol, Santander, Cantabria, Spain

[15] Hosp Clin Univ Albacete, Serv Cardiol, Albacete, Spain

[16] Hosp Murcia, Serv Cardiol, Murcia, Spain

[17] Complejo Hosp Burgos, Serv Cardiol, Burgos, Spain

[18] Hosp Univ Puerto Real, Serv Cardiol, Cadiz, Spain

[19] Hosp Jerez Frontera, Serv Cardiol, Cadiz, Spain

[20] Hosp Leon, Serv Cardiol, Leon, Spain

[21] Hosp Son Espases, Serv Cardiol, Palma de Mallorca, Balearic Island, Spain

[22] Hosp Cabuenes, Serv Cardiol, Gijon, Asturias, Spain

[23] Hosp La Paz, Serv Cardiol, Madrid, Spain

[24] Hosp Hospiten, Serv Cardiol, Santa Cruz De Tenerife, Spain

[25] Hosp Virgen Macarena, Serv Cardiol, Seville, Spain

[26] Hosp Bellvitge Princeps Espanya, Serv Cardiol, Barcelona, Spain

[27] Hosp Galdakao, Serv Cardiol, Galdakao, Vizcaya, Spain

[28] Hosp Ciudad Real, Serv Cardiol, Ciudad Real, Spain

[29] Hosp Alicante, Serv Cardiol, Alicante, Spain

[30] Hosp Clin Zaragoza, Serv Cardiol, Zaragoza, Spain

[31] Hosp Garcia Orta, Serv Cardiol, Almada, Portugal

[32] Hosp Espirito Santo, Serv Cardiol, Evora, Portugal

来源：

REVISTA ESPANOLA DE CARDIOLOGIA | 2019年 / 72卷 / 05期

关键词：

CTO; Chronic total occlusions; IVUS; Chronic ischemic cardiomyopathy; LEFT-VENTRICULAR FUNCTION; LONG-TERM MORTALITY; PERCUTANEOUS INTERVENTION; BALLOON ANGIOPLASTY; RADIATION-EXPOSURE; RETROGRADE; IMPACT; REVASCULARIZATION; BENEFITS; INSIGHTS;

D O I：

10.1016/j.rec.2018.05.020

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction and objectives: There is current controversy regarding the benefits of percutaneous recanalization (PCI) of chronic total coronary occlusions (CTO). Our aim was to determine acute and follow-up outcomes in our setting. Methods: Two-year prospective registry of consecutive patients undergoing PCI of CTO in 24 centers. Results: A total of 1000 PCIs of CTO were performed in 952 patients. Most were symptomatic (81.5%), with chronic ischemic heart disease (59.2%). Previous recanalization attempts had been made in 15%. The mean SYNTAX score was 19.5 +/- 10.6 and J-score was > 2 in 17.3%. A retrograde procedure was performed in 92 patients (9.2%). The success rate was 74.9% and was higher in patients without previous attempts (82.2% vs 75.2%; P = .001), those with a J-score <= 2 (80.5% vs 69.5%; P = .002), and in intravascular ultrasound-guided PCI (89.9% vs 76.2%, P = .001), which was an independent predictor of success. In contrast, severe calcification, length > 20 mm, and blunt proximal cap were independent predictors of failed recanalization. The rate of procedural complications was 7.1%, including perforation (3%), myocardial infarction (1.3%), and death (0.5%). At 1-year of follow-up, 88.2% of successfully revascularized patients showed clinical improvement (vs 34.8%, P < .001), which was associated with lower mortality. At 1-year of follow-up, the mortality rate was 1.5%. Conclusions: Compared with other national registries, patients in the Iberian registry undergoing PCI of a CTO showed similar complexity, success rate, and complications. Successful recanalization was strongly associated with functional improvement, which was related to lower mortality. (C) 2018 Published by Elsevier Espana, S.L.U. on behalf of Sociedad Espanola de Cardiologia.

引用

页码：373 / 382

页数：10

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