TY - JOUR
T1 - Left main chronic total occlusion percutaneous coronary intervention
T2 - A case series
AU - Xenogiannis, Iosif
AU - Karmpaliotis, Dimitri
AU - Alaswad, Khaldoon
AU - Basir, Mir B.
AU - Yeh, Robert W.
AU - Tamez, Hector
AU - Patel, Mitul
AU - Mahmud, Ehtisham
AU - Choi, James W.
AU - Burke, M. Nicholas
AU - Doing, Anthony H.
AU - Dattilo, Phil
AU - Khatri, Jaikirshan J.
AU - Sheikh, Abdul M.
AU - Malik, Bilal A.
AU - Greene, Mary E.
AU - Rafeh, Nidal Abi
AU - Maalouf, Assaad
AU - Jaoudeh, Fadi Abou
AU - Moses, Jeffrey W.
AU - Lembo, Nicholas J.
AU - Parikh, Manish
AU - Kirtane, Ajay J.
AU - Ali, Ziad A.
AU - Gkargkoulas, Fotis
AU - Russo, Juan
AU - Hakemi, Emad
AU - Tajti, Peter
AU - Hall, Allison B.
AU - Vemmou, Evangelia
AU - Nikolakopoulos, Ilias
AU - Rangan, Bavana Venkata
AU - Abdullah, Shuaib
AU - Banerjee, Subhash
AU - Brilakis, Emmanouil S.
N1 - Funding Information:
The PROGRESS-CTO registry has received support from the Abbott Northwestern Hospital Foundation, Minneapolis, Minnesota.
Publisher Copyright:
© 2019 HMP Communications. All rights reserved.
PY - 2019
Y1 - 2019
N2 - Background. Left main coronary artery (LMCA) chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. Methods. We reviewed 4436 CTO-PCIs performed in 4340 patients between 2012 and 2018 at 25 sites. LMCA-CTO-PCI was performed in 20 cases (0.45%). We examined the clinical and angiographic characteristics and procedural outcomes of these cases. Results. Mean patient age was 68 ± 11 years and 65% were men. Most patients (85%) had undergone prior coronary artery bypass graft surgery and had a protected left main. Mean J-CTO score was 2.7 ± 1.3, mean PROGRESS-CTO score was 1.3 ± 1.1, and mean PROGRESS-CTO Complications score was 3.8 ± 1.9. Antegrade-wire escalation was the most common successful crossing strategy (50%), followed by retrograde crossing (30%) and antegrade dissection/re-entry (10%). Technical and procedural success rates were both 85%. One patient with failed LMCA-CTO-PCI had periprocedural myocardial infarction. Median procedure time was 178 minutes (interquartile range [IQR], 123-250 minutes), median contrast volume was 190 mL (IQR, 133-339 mL), and patient air kerma radiation dose was 2.6 Gray (IQR, 1.3-3.9 Gray). Conclusions. LMCA-CTO-PCI is infrequent, is performed mostly in patients with prior coronary artery bypass graft surgery, and is associated with good procedural outcomes.
AB - Background. Left main coronary artery (LMCA) chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. Methods. We reviewed 4436 CTO-PCIs performed in 4340 patients between 2012 and 2018 at 25 sites. LMCA-CTO-PCI was performed in 20 cases (0.45%). We examined the clinical and angiographic characteristics and procedural outcomes of these cases. Results. Mean patient age was 68 ± 11 years and 65% were men. Most patients (85%) had undergone prior coronary artery bypass graft surgery and had a protected left main. Mean J-CTO score was 2.7 ± 1.3, mean PROGRESS-CTO score was 1.3 ± 1.1, and mean PROGRESS-CTO Complications score was 3.8 ± 1.9. Antegrade-wire escalation was the most common successful crossing strategy (50%), followed by retrograde crossing (30%) and antegrade dissection/re-entry (10%). Technical and procedural success rates were both 85%. One patient with failed LMCA-CTO-PCI had periprocedural myocardial infarction. Median procedure time was 178 minutes (interquartile range [IQR], 123-250 minutes), median contrast volume was 190 mL (IQR, 133-339 mL), and patient air kerma radiation dose was 2.6 Gray (IQR, 1.3-3.9 Gray). Conclusions. LMCA-CTO-PCI is infrequent, is performed mostly in patients with prior coronary artery bypass graft surgery, and is associated with good procedural outcomes.
KW - Chronic total occlusion
KW - Left main coronary artery
KW - Percutaneous coronary intervention
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M3 - Article
C2 - 31257217
AN - SCOPUS:85068977206
SN - 1042-3931
VL - 31
SP - E220-E225
JO - Journal of Invasive Cardiology
JF - Journal of Invasive Cardiology
IS - 7
ER -