Temporal Trends in Chronic Total Occlusion Percutaneous Coronary Interventions: Insights From the PROGRESS-CTO Registry

Iosif Xenogiannis, Fotios Gkargkoulas, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A. Jaffer, Robert W. Yeh, Mitul Patel, Ehtisham Mahmud, James W. Choi, M. Nicholas Burke, Santiago Garcia, Anthony H. Doing, Phil Dattilo, Catalin Toma, Barry Uretsky, Oleg Krestyaninov, Dmitrii Khelimskii, Jeffrey W. Moses, Nicholas J. Lembo, Manish ParikhAjay J. Kirtane, Ziad A. Ali, Juan J. Russo, Emad Hakemi, Allison B. Hall, Ilias Nikolakopoulos, Evangelia Vemmou, Aris Karatasakis, Barbara Danek, Bavana V. Rangan, Shuaib Abdullah, Subhash Banerjee, Emmanouil S. Brilakis

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

BACKGROUND: Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has significantly evolved in recent years. METHODS: We compared the clinical, angiographic, and technical characteristics, as well as procedural outcomes of CTO-PCIs in a multicenter registry between the "early era" (2012-2016) and the "current era" (2017-2019). RESULTS: Current era patients more often had stage III or IV angina compared with early era patients (71% vs 66%, respectively; P=.03) and were less likely to undergo ad hoc CTO-PCI (13% vs 16%, respectively; P=.04). The J-CTO score was slightly lower in the current era patients vs the early era patients (2.3 ± 1.4 vs 2.5 ± 1.3, respectively; P=.04). Use of antegrade wire escalation increased in the current era (92% vs 83% in the early era patients; P<.001) whereas use of retrograde crossing decreased (29% vs 39% in the early era; P<.001) and antegrade/ dissection re-entry decreased (23% vs 32% in the early era; P<.001). Technical success rates (85% in the current era vs 86% in the early era; P=.69) and procedural success rates (83% in the current era vs 85% in the early era; P=.15) were similar, whereas the incidence of in-hospital major cardiovascular events decreased in the current era (2% vs 3% in the early era; P=.04). CONCLUSIONS: During recent years, ad hoc CTO-PCI decreased along with decreasing use of retrograde crossing and antegrade dissection and re-entry. Technical and procedural success rates remained stable, whereas the incidence of in-hospital MACE decreased.

Original languageEnglish (US)
Pages (from-to)153-160
Number of pages8
JournalThe Journal of invasive cardiology
Volume32
Issue number4
StatePublished - Apr 1 2020

Keywords

  • chronic total occlusion
  • percutaneous coronary intervention
  • temporal trends

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Xenogiannis, I., Gkargkoulas, F., Karmpaliotis, D., Alaswad, K., Jaffer, F. A., Yeh, R. W., Patel, M., Mahmud, E., Choi, J. W., Burke, M. N., Garcia, S., Doing, A. H., Dattilo, P., Toma, C., Uretsky, B., Krestyaninov, O., Khelimskii, D., Moses, J. W., Lembo, N. J., ... Brilakis, E. S. (2020). Temporal Trends in Chronic Total Occlusion Percutaneous Coronary Interventions: Insights From the PROGRESS-CTO Registry. The Journal of invasive cardiology, 32(4), 153-160.