TY - JOUR
T1 - Procedural outcomes of revascularization of chronic total occlusion of native coronary arteries (from a multicenter United States registry)
AU - Michael, Tesfaldet T.
AU - Karmpaliotis, Dimitri
AU - Brilakis, Emmanouil S.
AU - Fuh, Eric
AU - Patel, Vishal G.
AU - Mogabgab, Owen
AU - Alomar, Mohammed
AU - Kirkland, Ben L.
AU - Lembo, Nicholas
AU - Kalynych, Anna
AU - Carlson, Harold
AU - Banerjee, Subhash
AU - Lombardi, William
AU - Kandzari, David E.
N1 - Funding Information:
Dr. Michael: Supported by Cardiovascular Training Grant from the National Institutes of Health Award Number T32HL007360. Dr. Karmpaliotis: Speaker bureau, Abbott Vascular and Medtronic; consultant, Bridgepoint Medical. Dr. Brilakis: Consulting fees/speaker honoraria from St. Jude Medical, Terumo and Bridgepoint Medical/Boston Scientific; research support from Guerbet; spouse is an employee of Medtronic. Dr. Lembo: Speaker bureau: Medtronic; advisory board Abbott Vascular and Medtronic. Dr. Banerjee: Speaker honoraria from St. Jude Medical, Medtronic, and Johnson & Johnson, Boehinger, Sanofi, Mdcare Global; research support from Boston Scientific and The Medicines Company. Dr. Lombardi: Consultant for Abbott Vascular, Bridgepoint Medical, Medtronic; Speaker honoraria from Abbott Vascular, Medtronic and Terumo; equity, Bridgepoint Medical. Dr. Kandzari: Research/grant support from Abbott Vascular, Boston Scientific Corporation and Medtronic Cardiovascular; Consultant, Boston Scientific Corporation and Medtronic Cardiovascular; Institutional educational grant from Bridgepoint Medical/Boston Scientific Corporation. The other authors have no conflicts of interest to disclose.
PY - 2013/8/15
Y1 - 2013/8/15
N2 - Percutaneous coronary intervention (PCI) of chronic total occlusions (CTOs) is a rapidly evolving area of interventional cardiology. We sought to examine the immediate procedural and in-hospital clinical outcomes of native coronary artery CTO PCI from a multicenter United States (US) registry. We retrospectively examined the procedural outcomes of 1,361 consecutive native coronary artery CTO PCIs performed at 3 US institutions from January 2006 to November 2011. Mean age was 65 ± 11 years, 85% of patients were men, 40% had diabetes, 37% had previous coronary artery bypass graft surgery, and 42% had previous PCI. The CTO target vessel was the right coronary artery (55%), circumflex (23%), left anterior descending artery (21%), and left main or bypass graft (1%). The retrograde approach was used in 34% of all procedures. The technical and procedural success rates were 85.5% and 84.2%, respectively. The mean procedural time, fluoroscopy time, and contrast utilization were 113 ± 61 minutes, 42 ± 29 minutes, and 294 ± 158 ml, respectively. In multivariate analysis, female gender, no previous coronary artery bypass surgery, and years since initiation of CTO PCI at each center were independent predictors of procedural success. Major complications occurred in 24 patients (1.8%). In conclusion, among selected US-based institutions with experienced operators, native coronary artery CTO PCI can be performed with high success and low major complication rates.
AB - Percutaneous coronary intervention (PCI) of chronic total occlusions (CTOs) is a rapidly evolving area of interventional cardiology. We sought to examine the immediate procedural and in-hospital clinical outcomes of native coronary artery CTO PCI from a multicenter United States (US) registry. We retrospectively examined the procedural outcomes of 1,361 consecutive native coronary artery CTO PCIs performed at 3 US institutions from January 2006 to November 2011. Mean age was 65 ± 11 years, 85% of patients were men, 40% had diabetes, 37% had previous coronary artery bypass graft surgery, and 42% had previous PCI. The CTO target vessel was the right coronary artery (55%), circumflex (23%), left anterior descending artery (21%), and left main or bypass graft (1%). The retrograde approach was used in 34% of all procedures. The technical and procedural success rates were 85.5% and 84.2%, respectively. The mean procedural time, fluoroscopy time, and contrast utilization were 113 ± 61 minutes, 42 ± 29 minutes, and 294 ± 158 ml, respectively. In multivariate analysis, female gender, no previous coronary artery bypass surgery, and years since initiation of CTO PCI at each center were independent predictors of procedural success. Major complications occurred in 24 patients (1.8%). In conclusion, among selected US-based institutions with experienced operators, native coronary artery CTO PCI can be performed with high success and low major complication rates.
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U2 - 10.1016/j.amjcard.2013.04.008
DO - 10.1016/j.amjcard.2013.04.008
M3 - Article
C2 - 23672987
AN - SCOPUS:84881164079
SN - 0002-9149
VL - 112
SP - 488
EP - 492
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 4
ER -