Impact of Calcium on Chronic Total Occlusion Percutaneous Coronary Interventions

被引：39

作者：

Karacsonyi, Judit ^{[1
,2
,3
,4
]}

Karmpaliotis, Dimitri ^{[5
]}

Alaswad, Khaldoon ^{[6
]}

Jaffer, Farouc A. ^{[7
,8
]}

Yeh, Robert W. ^{[9
]}

Patel, Mitul ^{[10
,11
]}

Mahmud, Ehtisham ^{[10
,11
]}

Lombardi, William ^{[12
]}

Wyman, Michael R. ^{[13
]}

Doing, Anthony ^{[14
]}

Moses, Jeffrey W. ^{[5
]}

Kirtane, Ajay ^{[5
]}

Parikh, Manish ^{[5
]}

Ali, Ziad ^{[5
]}

Kandzari, David ^{[15
]}

Lembo, Nicholas

Garcia, Santiago ^{[16
,17
]}

Danek, Barbara A. ^{[1
,2
]}

Karatasakis, Aris ^{[1
,2
]}

Resendes, Erica ^{[1
,2
]}

Kalsaria, Pratik ^{[1
,2
]}

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

Ungi, Imre ^{[3
,4
]}

Thompson, Craig A. ^{[18
]}

Banerjee, Subhash ^{[1
,2
]}

Brilakis, Emmanouil S. ^{[1
,2
,19
]}

机构：

[1] Vet Affairs North Texas Healthcare Syst, Dept Cardiol, Dallas, TX 75216 USA

[2] UT Southwestern Med Ctr, Dallas, TX 75390 USA

[3] Univ Szeged, Dept Internal Med 2, Div Invas Cardiol, Szeged, Hungary

[4] Univ Szeged, Cardiol Ctr, Szeged, Hungary

[5] Columbia Univ, Intervent Cardiol, New York, NY USA

[6] Henry Ford Hosp, Cardiac Catheterizat Lab, Detroit, MI 48202 USA

[7] Massachusetts Gen Hosp, Coronary Intervent, Boston, MA 02114 USA

[8] Harvard Med Sch, Boston, MA USA

[9] Beth Israel Deaconess Med Ctr, Intervent Cardiol, Boston, MA 02215 USA

[10] Vet Affairs San Diego Healthcare Syst, Div Cardiovasc Med, San Diego, CA USA

[11] Univ Calif San Diego, San Diego, CA 92103 USA

[12] Univ Washington, Div Cardiol, Seattle, WA 98195 USA

[13] Torrance Mem Med Ctr, Cardiac Catheterizat Lab, Torrance, CA USA

[14] Med Ctr Rockies, Dept Cardiol, Loveland, CO USA

[15] Piedmont Heart Inst, Intervent Cardiol, Atlanta, GA USA

[16] Minneapolis Vet Affairs Healthcare Syst, Dept Med, Minneapolis, MN USA

[17] Univ Minnesota, Minneapolis, MN USA

[18] Boston Sci, Intervent Cardiol, Natick, MA USA

[19] Minneapolis Heart Inst, Ctr Adv Coronary Intervent, Minneapolis, MN 55407 USA

来源：

AMERICAN JOURNAL OF CARDIOLOGY | 2017年 / 120卷 / 01期

关键词：

ELUTING STENT IMPLANTATION; MULTICENTER US REGISTRY; LEVEL POOLED ANALYSIS; LONG-TERM OUTCOMES; INTRAVASCULAR ULTRASOUND; ARTERY-DISEASE; ROTATIONAL ATHERECTOMY; COMPUTED-TOMOGRAPHY; HYBRID APPROACH; CALCIFICATION;

D O I：

10.1016/j.amjcard.2017.03.263

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

We sought to examine the impact of calcific deposits on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). The outcomes of 1,476 consecutive CTO PCIs performed in 1,453 patients (65.5 +/- 10 years, 85% male) between 2012 and 2016 at 11 US centers were evaluated. Moderate or severe quantity of calcium was present in 58% of target lesions. Calcified lesions were more tortuous and more likely to have proximal cap ambiguity and interventional collaterals. PCI of moderately/severely calcified CTOs more often required use of the retrograde approach (54% vs 30%, p <0.001) and was associated with longer procedure and fluoroscopy time and higher air kerma radiation dose and contrast volume. Moderate/severe quantity of calcium was associated with lower technical (86.6% vs 93.8%, p <0.001) and procedural (84.4% vs 92.7%, p <0.001) success rates and higher incidence of major adverse cardiac events (3.7% vs 1.8%, p = 0.033). On multivariate analysis, the presence of moderate/severe quantity of calcium was not independently associated with technical success. Balloon angioplasty was the most common lesion preparation technique for calcified lesions, followed by rotational atherectomy and laser. To conclude, in a contemporary, multicenter registry, moderate/severe calcific deposits were present in 58% of attempted CTO lesions and were associated with higher use of the retrograde approach, lower success, and higher complication rates. However, on multivariable analysis, the amount of calcium was not independently associated with technical success. (C) 2017 Elsevier Inc. All rights reserved.

引用

页码：40 / 46

页数：7

共 28 条

[1] High-Speed Rotational Atherectomy Before Paclitaxel-Eluting Stent Implantation in Complex Calcified Coronary Lesions The Randomized ROTAXUS (Rotational Atherectomy Prior to Taxus Stent Treatment for Complex Native Coronary Artery Disease) Trial [J].

Abdel-Wahab, Mohamed ;

Richardt, Gert ;

Buettner, Heinz Joachim ;

Toelg, Ralph ;

Geist, Volker ;

Meinertz, Thomas ;

Schofer, Joachim ;

King, Lamin ;

Neumann, Franz-Josef ;

Khattab, Ahmed A. .

JACC-CARDIOVASCULAR INTERVENTIONS, 2013, 6 (01) :10-19

[2] Prognostic implications of coronary calcification in patients with obstructive coronary artery disease treated by percutaneous coronary intervention: a patient-level pooled analysis of 7 contemporary stent trials [J].

Bourantas, Christos V. ;

Zhang, Yao-Jun ;

Garg, Scot ;

Iqbal, Javaid ;

Valgimigli, Marco ;

Windecker, Stephan ;

Mohr, Friedrich W. ;

Silber, Sigmund ;

de Vries, Ton ;

Onuma, Yoshinobu ;

Garcia-Garcia, Hector M. ;

Morel, Marie-Angele ;

Serruys, Patrick W. .

HEART, 2014, 100 (15) :1158-1164

[3] Current status of rotational atherectomy [J].

Cavusoglu, E ;

Kini, AS ;

Marmur, JD ;

Sharma, SK .

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2004, 62 (04) :485-498

[4] Development and Validation of a Novel Scoring System for Predicting Technical Success of Chronic Total Occlusion Percutaneous Coronary Interventions The PROGRESS CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) Score [J].

Christopoulos, Georgios ;

Kandzari, David E. ;

Yeh, Robert W. ;

Jaffer, Farouc A. ;

Karmpaliotis, Dimitri ;

Wyman, Michael R. ;

Alaswad, Khaldoon ;

Lombardi, William ;

Grantham, J. Aaron ;

Moses, Jeffrey ;

Christakopoulos, Georgios ;

Rangan, Bavana V. ;

Lembo, Nicholas ;

Garcia, Santiago ;

Cipher, Daisha ;

Thompson, Craig A. ;

Banerjee, Subhash ;

Brilakis, Emmanouil S. .

JACC-CARDIOVASCULAR INTERVENTIONS, 2016, 9 (01) :1-9

[5] Application and outcomes of a hybrid approach to chronic total occlusion percutaneous coronary intervention in a contemporary multicenter US registry [J].

Christopoulos, Georgios ;

Karmpaliotis, Dimitri ;

Alaswad, Khaldoon ;

Yeh, Robert W. ;

Jaffer, Farouc A. ;

Wyman, R. Michael ;

Lombardi, William L. ;

Menon, Rohan V. ;

Grantham, J. Aaron ;

Kandzari, David E. ;

Lembo, Nicholas ;

Moses, Jeffrey W. ;

Kirtane, Ajay J. ;

Parikh, Manish ;

Green, Philip ;

Finn, Matthew ;

Garcia, Santiago ;

Doing, Anthony ;

Patel, Mitul ;

Bahadorani, John ;

Tarar, Muhammad Nauman J. ;

Christakopoulos, Georgios E. ;

Thompson, Craig A. ;

Banerjee, Subhash ;

Brilakis, Emmanouil S. .

INTERNATIONAL JOURNAL OF CARDIOLOGY, 2015, 198 :222-228

[6]

Christopoulos G, 2014, J INVASIVE CARDIOL, V26, P427

[7] Development and Validation of a Scoring System for Predicting Periprocedural Complications During Percutaneous Coronary Interventions of Chronic Total Occlusions: The Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS CTO) Complications Score [J].

Danek, Barbara Anna ;

Karatasakis, Aris ;

Karmpaliotis, Dimitri ;

Alaswad, Khaldoon ;

Yeh, Robert W. ;

Jaffer, Farouc A. ;

Patel, Mitul P. ;

Mahmud, Ehtisham ;

Lombardi, William L. ;

Wyman, Michael R. ;

Grantham, J. Aaron ;

Doing, Anthony ;

Kandzari, David E. ;

Lembo, Nicholas J. ;

Garcia, Santiago ;

Toma, Catalin ;

Moses, Jeffrey W. ;

Kirtane, Ajay J. ;

Parikh, Manish A. ;

Ali, Ziad A. ;

Karacsonyi, Judit ;

Rangan, Bavana V. ;

Thompson, Craig A. ;

Banerjee, Subhash ;

Brilakis, Emmanouil S. .

JOURNAL OF THE AMERICAN HEART ASSOCIATION, 2016, 5 (10)

[8] CONTRIBUTION OF LOCALIZED CALCIUM DEPOSITS TO DISSECTION AFTER ANGIOPLASTY - AN OBSERVATIONAL STUDY USING INTRAVASCULAR ULTRASOUND [J].

FITZGERALD, PJ ;

PORTS, TA ;

YOCK, PG .

CIRCULATION, 1992, 86 (01) :64-70

[9] Impact of Calcification on the Long-Term Outcomes of Sirolimus-Eluting Stent Implantation - Subanalysis of the Cypher Post-Marketing Surveillance Registry [J].

Fujimoto, Hajime ;

Nakamura, Masato ;

Yokoi, Hiroyoshi .

CIRCULATION JOURNAL, 2012, 76 (01) :57-64

[10] Retrograde Recanalization of Chronic Total Occlusions in Europe Procedural, In-Hospital, and Long-Term Outcomes From the Multicenter ERCTO Registry [J].

Galassi, Alfredo R. ;

Sianos, Georgios ;

Werner, Gerald S. ;

Escaned, Javier ;

Tomasello, Salvatore D. ;

Boukhris, Marouane ;

Castaing, Marine ;

Buettner, Joachim H. ;

Bufe, Alexander ;

Kalnins, Artis ;

Spratt, James C. ;

Garbo, Roberto ;

Hildick-Smith, David ;

Elhadad, Simon ;

Gagnor, Andrea ;

Lauer, Bernward ;

Bryniarski, Leszek ;

Christiansen, Evald H. ;

Thuesen, Leif ;

Meyer-Gessner, Markus ;

Goktekin, Omer ;

Carlino, Mauro ;

Louvard, Yves ;

Lefevre, Thierry ;

Lismanis, Aigars ;

Gelev, Valery L. ;

Serra, Antonio ;

Marza, Francesco ;

Di Mario, Carlo ;

Reifart, Nicolaus .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2015, 65 (22) :2388-2400

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