Effect of Previous Failure on Subsequent Procedural Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention (from a Contemporary Multicenter Registry)

Judit Karacsonyi, Aris Karatasakis, Dimitri Karmpaliotis, Khaldoon Alaswad, Robert W. Yeh, Farouc A. Jaffer, Michael R. Wyman, William L. Lombardi, J. Aaron Grantham, David E. Kandzari, Nicholas Lembo, Jeffrey W. Moses, Ajay J. Kirtane, Manish A. Parikh, Philip Green, Matthew Finn, Santiago Garcia, Anthony Doing, Mitul Patel, John BahadoraniJose Roberto Martinez Parachini, Erica Resendes, Bavana V. Rangan, Imre Ungi, Craig A. Thompson, Subhash Banerjee, Emmanouil S. Brilakis

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

We sought to examine the impact of previous failure on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We examined the clinical and angiographic characteristics and procedural outcomes of 1,213 consecutive patients who underwent 1,232 CTO PCIs from 2012 to 2015 at 12 US centers. Mean age was 65 ± 10 years, and 84.8% of patients were men. A previously failed attempt had been performed in 215 patients (17.5%). As compared with patients without previous CTO PCI failure, patients with previous failure had higher Multicenter CTO Registry in Japan CTO score (2.40 ± 1.13 vs 3.28 ± 1.29, p <0.0001) and were more likely to have in-stent restenosis (10.5% vs 28.4%, p <0.0001) and to undergo recanalization attempts using the retrograde approach (41% vs 50%, p = 0.011). Technical (90% vs 88%, p = 0.390) and procedural (89% vs 86%, p = 0.184) success were similar in the 2 study groups; however, median procedure time (125 vs 142 minutes, p = 0.026) and fluoroscopy time (45 vs 55 minutes, p = 0.015) were longer in the previous failure group. In conclusion, a previously failed CTO PCI attempt is associated with higher angiographic complexity, longer procedural duration, and fluoroscopy time, but not with the success and complication rates of subsequent CTO PCI attempts.

Original languageEnglish (US)
Pages (from-to)1267-1271
Number of pages5
JournalAmerican Journal of Cardiology
Volume117
Issue number8
DOIs
StatePublished - Apr 15 2016

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Karacsonyi, J., Karatasakis, A., Karmpaliotis, D., Alaswad, K., Yeh, R. W., Jaffer, F. A., Wyman, M. R., Lombardi, W. L., Grantham, J. A., Kandzari, D. E., Lembo, N., Moses, J. W., Kirtane, A. J., Parikh, M. A., Green, P., Finn, M., Garcia, S., Doing, A., Patel, M., ... Brilakis, E. S. (2016). Effect of Previous Failure on Subsequent Procedural Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention (from a Contemporary Multicenter Registry). American Journal of Cardiology, 117(8), 1267-1271. https://doi.org/10.1016/j.amjcard.2016.01.021