Impact of Calcium on Chronic Total Occlusion Percutaneous Coronary Interventions

Judit Karacsonyi, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A. Jaffer, Robert W. Yeh, Mitul Patel, Ehtisham Mahmud, William Lombardi, Michael R. Wyman, Anthony Doing, Jeffrey W. Moses, Ajay Kirtane, Manish Parikh, Ziad Ali, David Kandzari, Nicholas Lembo, Santiago Garcia, Barbara A. Danek, Aris Karatasakis, Erica ResendesPratik Kalsaria, Bavana V. Rangan, Imre Ungi, Craig A. Thompson, Subhash Banerjee, Emmanouil S. Brilakis

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)40-46
Number of pages7
JournalAmerican Journal of Cardiology
Volume120
Issue number1
DOIs
StatePublished - Jul 1 2017

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Percutaneous Coronary Intervention
Calcium
Coronary Atherectomy
Balloon Angioplasty
Fluoroscopy
Registries
Lasers
Multivariate Analysis
Air
Radiation
Incidence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Impact of Calcium on Chronic Total Occlusion Percutaneous Coronary Interventions. / Karacsonyi, Judit; Karmpaliotis, Dimitri; Alaswad, Khaldoon; Jaffer, Farouc A.; Yeh, Robert W.; Patel, Mitul; Mahmud, Ehtisham; Lombardi, William; Wyman, Michael R.; Doing, Anthony; Moses, Jeffrey W.; Kirtane, Ajay; Parikh, Manish; Ali, Ziad; Kandzari, David; Lembo, Nicholas; Garcia, Santiago; Danek, Barbara A.; Karatasakis, Aris; Resendes, Erica; Kalsaria, Pratik; Rangan, Bavana V.; Ungi, Imre; Thompson, Craig A.; Banerjee, Subhash; Brilakis, Emmanouil S.

In: American Journal of Cardiology, Vol. 120, No. 1, 01.07.2017, p. 40-46.

Research output: Contribution to journalArticle

Karacsonyi, J, Karmpaliotis, D, Alaswad, K, Jaffer, FA, Yeh, RW, Patel, M, Mahmud, E, Lombardi, W, Wyman, MR, Doing, A, Moses, JW, Kirtane, A, Parikh, M, Ali, Z, Kandzari, D, Lembo, N, Garcia, S, Danek, BA, Karatasakis, A, Resendes, E, Kalsaria, P, Rangan, BV, Ungi, I, Thompson, CA, Banerjee, S & Brilakis, ES 2017, 'Impact of Calcium on Chronic Total Occlusion Percutaneous Coronary Interventions', American Journal of Cardiology, vol. 120, no. 1, pp. 40-46. https://doi.org/10.1016/j.amjcard.2017.03.263
Karacsonyi J, Karmpaliotis D, Alaswad K, Jaffer FA, Yeh RW, Patel M et al. Impact of Calcium on Chronic Total Occlusion Percutaneous Coronary Interventions. American Journal of Cardiology. 2017 Jul 1;120(1):40-46. https://doi.org/10.1016/j.amjcard.2017.03.263
Karacsonyi, Judit ; Karmpaliotis, Dimitri ; Alaswad, Khaldoon ; Jaffer, Farouc A. ; Yeh, Robert W. ; Patel, Mitul ; Mahmud, Ehtisham ; Lombardi, William ; Wyman, Michael R. ; Doing, Anthony ; Moses, Jeffrey W. ; Kirtane, Ajay ; Parikh, Manish ; Ali, Ziad ; Kandzari, David ; Lembo, Nicholas ; Garcia, Santiago ; Danek, Barbara A. ; Karatasakis, Aris ; Resendes, Erica ; Kalsaria, Pratik ; Rangan, Bavana V. ; Ungi, Imre ; Thompson, Craig A. ; Banerjee, Subhash ; Brilakis, Emmanouil S. / Impact of Calcium on Chronic Total Occlusion Percutaneous Coronary Interventions. In: American Journal of Cardiology. 2017 ; Vol. 120, No. 1. pp. 40-46.
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AU - Alaswad, Khaldoon

AU - Jaffer, Farouc A.

AU - Yeh, Robert W.

AU - Patel, Mitul

AU - Mahmud, Ehtisham

AU - Lombardi, William

AU - Wyman, Michael R.

AU - Doing, Anthony

AU - Moses, Jeffrey W.

AU - Kirtane, Ajay

AU - Parikh, Manish

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AU - Lembo, Nicholas

AU - Garcia, Santiago

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AU - Karatasakis, Aris

AU - Resendes, Erica

AU - Kalsaria, Pratik

AU - Rangan, Bavana V.

AU - Ungi, Imre

AU - Thompson, Craig A.

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AU - Brilakis, Emmanouil S.

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