The Impact of Peripheral Artery Disease in Chronic Total Occlusion Percutaneous Coronary Intervention (Insights From PROGRESS-CTO Registry)

Iosif Xenogiannis; Fotis Gkargkoulas; Dimitri Karmpaliotis; Khaldoon Alaswad; Oleg Krestyaninov; Dmitrii Khelimskii; James W. Choi; Farouc A. Jaffer; Mitul Patel; Ehtisham Mahmud; Jaikirshan J. Khatri; David E. Kandzari; Anthony H. Doing; Phil Dattilo; Catalin Toma; Michalis Koutouzis; Ioannis Tsiafoutis; Barry Uretsky; Robert W. Yeh; Hector Tamez; R. Michael Wyman; Brian K. Jefferson; Taral Patel; Wissam Jaber; Habib Samady; Abdul M. Sheikh; Bilal A. Malik; Elizabeth Holper; Srinivasa Potluri; Jeffrey W. Moses; Nicholas J. Lembo; Manish Parikh; Ajay J. Kirtane; Ziad A. Ali; Allison B. Hall; Evangelia Vemmou; Ilias Nikolakopoulos; Bassel Bou Dargham; Bavana Venkata Rangan; Shuaib Abdullah; Santiago Garcia; Subhash Banerjee; M. Nicholas Burke; Emmanouil S. Brilakis

doi:10.1177/0003319719895178

The Impact of Peripheral Artery Disease in Chronic Total Occlusion Percutaneous Coronary Intervention (Insights From PROGRESS-CTO Registry)

Iosif Xenogiannis, Fotis Gkargkoulas, Dimitri Karmpaliotis, Khaldoon Alaswad, Oleg Krestyaninov, Dmitrii Khelimskii, James W. Choi, Farouc A. Jaffer, Mitul Patel, Ehtisham Mahmud, Jaikirshan J. Khatri, David E. Kandzari, Anthony H. Doing, Phil Dattilo, Catalin Toma, Michalis Koutouzis, Ioannis Tsiafoutis, Barry Uretsky, Robert W. Yeh, Hector TamezR. Michael Wyman, Brian K. Jefferson, Taral Patel, Wissam Jaber, Habib Samady, Abdul M. Sheikh, Bilal A. Malik, Elizabeth Holper, Srinivasa Potluri, Jeffrey W. Moses, Nicholas J. Lembo, Manish Parikh, Ajay J. Kirtane, Ziad A. Ali, Allison B. Hall, Evangelia Vemmou, Ilias Nikolakopoulos, Bassel Bou Dargham, Bavana Venkata Rangan, Shuaib Abdullah, Santiago Garcia, Subhash Banerjee, M. Nicholas Burke, Emmanouil S. Brilakis

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

The impact of peripheral artery disease (PAD) in patients undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. We reviewed 3999 CTO PCIs performed in 3914 patients between 2012 and 2018 at 25 centers, 14% of whom had a history of PAD. We compared the clinical and angiographic characteristics and procedural outcomes of patients with versus without history of PAD. Patients with PAD were older (67 ± 9 vs 64 ± 10 years, P <.001) and had a higher prevalence of cardiovascular risk factors. They also had more complex lesions as illustrated by higher Japanese CTO score (2.7 ± 1.2 vs 2.4 ± 1.3, P <.001). In patients with PAD, the final crossing technique was less often antegrade wire escalation (40% vs 51%, P <.001) and more often the retrograde approach (23 vs 20%, P <.001) and antegrade dissection/reentry (20% vs 16%, P <.001). Technical success was similar between the 2 study groups (84% vs 87%, P =.127), but procedural success was lower for patients with PAD (81% vs 85%, P =.015). The incidence of in-hospital major adverse cardiac events was higher among patients with PAD (3% vs 2%, P =.046). In conclusion, patients with PAD undergoing CTO PCI have more comorbidities, more complex lesions, and lower procedural success.

Original language	English (US)
Pages (from-to)	274-280
Number of pages	7
Journal	Angiology
Volume	71
Issue number	3
DOIs	https://doi.org/10.1177/0003319719895178
State	Published - Mar 1 2020

Keywords

chronic total occlusion
percutaneous coronary intervention
peripheral artery disease

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

Access to Document

10.1177/0003319719895178

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Xenogiannis, I., Gkargkoulas, F., Karmpaliotis, D., Alaswad, K., Krestyaninov, O., Khelimskii, D., Choi, J. W., Jaffer, F. A., Patel, M., Mahmud, E., Khatri, J. J., Kandzari, D. E., Doing, A. H., Dattilo, P., Toma, C., Koutouzis, M., Tsiafoutis, I., Uretsky, B., Yeh, R. W., ... Brilakis, E. S. (2020). The Impact of Peripheral Artery Disease in Chronic Total Occlusion Percutaneous Coronary Intervention (Insights From PROGRESS-CTO Registry). Angiology, 71(3), 274-280. https://doi.org/10.1177/0003319719895178

Xenogiannis, I, Gkargkoulas, F, Karmpaliotis, D, Alaswad, K, Krestyaninov, O, Khelimskii, D, Choi, JW, Jaffer, FA, Patel, M, Mahmud, E, Khatri, JJ, Kandzari, DE, Doing, AH, Dattilo, P, Toma, C, Koutouzis, M, Tsiafoutis, I, Uretsky, B, Yeh, RW, Tamez, H, Wyman, RM, Jefferson, BK, Patel, T, Jaber, W, Samady, H, Sheikh, AM, Malik, BA, Holper, E, Potluri, S, Moses, JW, Lembo, NJ, Parikh, M, Kirtane, AJ, Ali, ZA, Hall, AB, Vemmou, E, Nikolakopoulos, I, Dargham, BB, Rangan, BV, Abdullah, S, Garcia, S, Banerjee, S, Burke, MN & Brilakis, ES 2020, 'The Impact of Peripheral Artery Disease in Chronic Total Occlusion Percutaneous Coronary Intervention (Insights From PROGRESS-CTO Registry)', Angiology, vol. 71, no. 3, pp. 274-280. https://doi.org/10.1177/0003319719895178

@article{003a0988f4d7467b9959798d997d7495,

title = "The Impact of Peripheral Artery Disease in Chronic Total Occlusion Percutaneous Coronary Intervention (Insights From PROGRESS-CTO Registry)",

abstract = "The impact of peripheral artery disease (PAD) in patients undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. We reviewed 3999 CTO PCIs performed in 3914 patients between 2012 and 2018 at 25 centers, 14% of whom had a history of PAD. We compared the clinical and angiographic characteristics and procedural outcomes of patients with versus without history of PAD. Patients with PAD were older (67 ± 9 vs 64 ± 10 years, P <.001) and had a higher prevalence of cardiovascular risk factors. They also had more complex lesions as illustrated by higher Japanese CTO score (2.7 ± 1.2 vs 2.4 ± 1.3, P <.001). In patients with PAD, the final crossing technique was less often antegrade wire escalation (40% vs 51%, P <.001) and more often the retrograde approach (23 vs 20%, P <.001) and antegrade dissection/reentry (20% vs 16%, P <.001). Technical success was similar between the 2 study groups (84% vs 87%, P =.127), but procedural success was lower for patients with PAD (81% vs 85%, P =.015). The incidence of in-hospital major adverse cardiac events was higher among patients with PAD (3% vs 2%, P =.046). In conclusion, patients with PAD undergoing CTO PCI have more comorbidities, more complex lesions, and lower procedural success.",

keywords = "chronic total occlusion, percutaneous coronary intervention, peripheral artery disease",

author = "Iosif Xenogiannis and Fotis Gkargkoulas and Dimitri Karmpaliotis and Khaldoon Alaswad and Oleg Krestyaninov and Dmitrii Khelimskii and Choi, {James W.} and Jaffer, {Farouc A.} and Mitul Patel and Ehtisham Mahmud and Khatri, {Jaikirshan J.} and Kandzari, {David E.} and Doing, {Anthony H.} and Phil Dattilo and Catalin Toma and Michalis Koutouzis and Ioannis Tsiafoutis and Barry Uretsky and Yeh, {Robert W.} and Hector Tamez and Wyman, {R. Michael} and Jefferson, {Brian K.} and Taral Patel and Wissam Jaber and Habib Samady and Sheikh, {Abdul M.} and Malik, {Bilal A.} and Elizabeth Holper and Srinivasa Potluri and Moses, {Jeffrey W.} and Lembo, {Nicholas J.} and Manish Parikh and Kirtane, {Ajay J.} and Ali, {Ziad A.} and Hall, {Allison B.} and Evangelia Vemmou and Ilias Nikolakopoulos and Dargham, {Bassel Bou} and Rangan, {Bavana Venkata} and Shuaib Abdullah and Santiago Garcia and Subhash Banerjee and Burke, {M. Nicholas} and Brilakis, {Emmanouil S.}",

note = "Funding Information: Study data were collected and managed using Research Electronic Data Capture (REDCap) electronic data capture tools hosted at the Minneapolis Heart Institute Foundation (MHIF), Minneapolis, Minnesota. REDCap is a secure, web-based application designed to support data capture for research studies, providing (1) an intuitive interface for validated data entry, (2) audit trails for tracking data manipulation and export procedures, (3) automated export procedures for seamless data downloads to common statistical packages, and (4) procedures for importing data from external sources. Declaration of Conflicting Interests The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Karmpaliotis: speaker honoraria: Abbott Vascular, Boston Scientific, Medtronic, Vascular Solutions. Dr. Alaswaad: consulting fees from Terumo and Boston Scientific; consultant, no financial, Abbott Laboratories. Dr. Jaffer: consultant: Abbott Vascular, Boston Scientific and Siemens. Research grant: Canon, Siemens and National Institutes of Health. Dr. M. Patel: speakers{\textquoteright} bureau for Astra Zeneca. Dr. Mahmud: consulting fees from Medtronic and Corindus; speaker{\textquoteright}s fees from Medtronic, Corindus, and Abbott Vascular; educational program fees from Abbott Vascular; and clinical events committee fees from St. Jude. Dr. Khatri: Asahi Intecc. Speaker/Proctor: Abbott Vascular. Dr. Kandzari: research grant: Boston Scientific and Medtronic Cardiovascular, Abbott. Consultant/Advisory Board: Boston Scientific and Medtronic Cardiovascular. Dr. Yeh: career development award (1K23HL118138) from the National Heart, Lung, and Blood Institute. Dr. Wyman: Speaker{\textquoteright}s bureau: Boston Scientific, Abbott Vascular, and Asahi. Honoraria: Boston Scientific, Abbott Vascular, and Asahi. Consultant/Advisory Board: Boston Scientific, Abbott Vascular, and Asahi. Dr. Jefferson: honoraria/consulting/speaking fees from Abbott, Boston Scientific, CSI, Medtronic. Dr. Moses: consultant to Boston Scientific and Abiomed. Dr. Lembo: speaker bureau: Medtronic. Consultant/Advisory Board: Abbott Vascular and Medtronic. Dr. Parikh: speaker bureau: Abbot Vascular, Medtronic, CSI, BSC, Trireme; advisory boards: Medtronic, Abbott Vascular, Philips. Dr. Kirtane: Institutional research grants to Columbia University from Boston Scientific, Medtronic, Abbott Vascular, Abiomed, St. Jude Medical, Vascular Dynamics, Glaxo SmithKline, and Eli Lilly. Dr. Ali: consultant fees/honoraria from St. Jude Medical, and AstraZeneca Pharmaceuticals; ownership interest/partnership/principal in Shockwave Medical and VitaBx Inc; and research grants from Medtronic and St. Jude Medical. Dr. Rangan: research grants from InfraReDx, Inc., and The Spectranetics Corporation. Dr. Garcia: consulting fees from Medtronic. Dr. Banerjee: research grants from Gilead and the Medicines Company; consultant/speaker honoraria from Covidien and Medtronic; ownership in MDCARE Global (spouse); intellectual property in HygeiaTel. Dr. Burke: consulting and speaker honoraria from Abbott Vascular and Boston Scientific. Dr. Brilakis: consulting/speaker honoraria from Abbott Vascular, American Heart Association (associate editor Circulation), Boston Scientific, Cardiovascular Innovations Foundation (Board of Directors), CSI, Elsevier, GE Healthcare, and Medtronic; research support from Siemens, Regeneron, and Osprey. Shareholder: MHI Ventures. Board of Trustees: Society of Cardiovascular Angiography and Interventions. Funding The author(s) disclosed receipt of the following financial support for the research and/or authorship of this article: The Progress CTO registry has received support from the Abbott Northwestern Hospital Foundation, Minneapolis, MN. ORCID iDs Iosif Xenogiannis https://orcid.org/0000-0002-5004-6635 Emmanouil S. Brilakis https://orcid.org/0000-0001-9416-9701 Publisher Copyright: {\textcopyright} The Author(s) 2019.",

year = "2020",

month = mar,

day = "1",

doi = "10.1177/0003319719895178",

language = "English (US)",

volume = "71",

pages = "274--280",

journal = "Angiology",

issn = "0003-3197",

publisher = "SAGE Publications Inc.",

number = "3",

}

TY - JOUR

T1 - The Impact of Peripheral Artery Disease in Chronic Total Occlusion Percutaneous Coronary Intervention (Insights From PROGRESS-CTO Registry)

AU - Xenogiannis, Iosif

AU - Gkargkoulas, Fotis

AU - Karmpaliotis, Dimitri

AU - Alaswad, Khaldoon

AU - Krestyaninov, Oleg

AU - Khelimskii, Dmitrii

AU - Choi, James W.

AU - Jaffer, Farouc A.

AU - Patel, Mitul

AU - Mahmud, Ehtisham

AU - Khatri, Jaikirshan J.

AU - Kandzari, David E.

AU - Doing, Anthony H.

AU - Dattilo, Phil

AU - Toma, Catalin

AU - Koutouzis, Michalis

AU - Tsiafoutis, Ioannis

AU - Uretsky, Barry

AU - Yeh, Robert W.

AU - Tamez, Hector

AU - Wyman, R. Michael

AU - Jefferson, Brian K.

AU - Patel, Taral

AU - Jaber, Wissam

AU - Samady, Habib

AU - Sheikh, Abdul M.

AU - Malik, Bilal A.

AU - Holper, Elizabeth

AU - Potluri, Srinivasa

AU - Moses, Jeffrey W.

AU - Lembo, Nicholas J.

AU - Parikh, Manish

AU - Kirtane, Ajay J.

AU - Ali, Ziad A.

AU - Hall, Allison B.

AU - Vemmou, Evangelia

AU - Nikolakopoulos, Ilias

AU - Dargham, Bassel Bou

AU - Rangan, Bavana Venkata

AU - Abdullah, Shuaib

AU - Garcia, Santiago

AU - Banerjee, Subhash

AU - Burke, M. Nicholas

AU - Brilakis, Emmanouil S.

N1 - Funding Information: Study data were collected and managed using Research Electronic Data Capture (REDCap) electronic data capture tools hosted at the Minneapolis Heart Institute Foundation (MHIF), Minneapolis, Minnesota. REDCap is a secure, web-based application designed to support data capture for research studies, providing (1) an intuitive interface for validated data entry, (2) audit trails for tracking data manipulation and export procedures, (3) automated export procedures for seamless data downloads to common statistical packages, and (4) procedures for importing data from external sources. Declaration of Conflicting Interests The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Karmpaliotis: speaker honoraria: Abbott Vascular, Boston Scientific, Medtronic, Vascular Solutions. Dr. Alaswaad: consulting fees from Terumo and Boston Scientific; consultant, no financial, Abbott Laboratories. Dr. Jaffer: consultant: Abbott Vascular, Boston Scientific and Siemens. Research grant: Canon, Siemens and National Institutes of Health. Dr. M. Patel: speakers’ bureau for Astra Zeneca. Dr. Mahmud: consulting fees from Medtronic and Corindus; speaker’s fees from Medtronic, Corindus, and Abbott Vascular; educational program fees from Abbott Vascular; and clinical events committee fees from St. Jude. Dr. Khatri: Asahi Intecc. Speaker/Proctor: Abbott Vascular. Dr. Kandzari: research grant: Boston Scientific and Medtronic Cardiovascular, Abbott. Consultant/Advisory Board: Boston Scientific and Medtronic Cardiovascular. Dr. Yeh: career development award (1K23HL118138) from the National Heart, Lung, and Blood Institute. Dr. Wyman: Speaker’s bureau: Boston Scientific, Abbott Vascular, and Asahi. Honoraria: Boston Scientific, Abbott Vascular, and Asahi. Consultant/Advisory Board: Boston Scientific, Abbott Vascular, and Asahi. Dr. Jefferson: honoraria/consulting/speaking fees from Abbott, Boston Scientific, CSI, Medtronic. Dr. Moses: consultant to Boston Scientific and Abiomed. Dr. Lembo: speaker bureau: Medtronic. Consultant/Advisory Board: Abbott Vascular and Medtronic. Dr. Parikh: speaker bureau: Abbot Vascular, Medtronic, CSI, BSC, Trireme; advisory boards: Medtronic, Abbott Vascular, Philips. Dr. Kirtane: Institutional research grants to Columbia University from Boston Scientific, Medtronic, Abbott Vascular, Abiomed, St. Jude Medical, Vascular Dynamics, Glaxo SmithKline, and Eli Lilly. Dr. Ali: consultant fees/honoraria from St. Jude Medical, and AstraZeneca Pharmaceuticals; ownership interest/partnership/principal in Shockwave Medical and VitaBx Inc; and research grants from Medtronic and St. Jude Medical. Dr. Rangan: research grants from InfraReDx, Inc., and The Spectranetics Corporation. Dr. Garcia: consulting fees from Medtronic. Dr. Banerjee: research grants from Gilead and the Medicines Company; consultant/speaker honoraria from Covidien and Medtronic; ownership in MDCARE Global (spouse); intellectual property in HygeiaTel. Dr. Burke: consulting and speaker honoraria from Abbott Vascular and Boston Scientific. Dr. Brilakis: consulting/speaker honoraria from Abbott Vascular, American Heart Association (associate editor Circulation), Boston Scientific, Cardiovascular Innovations Foundation (Board of Directors), CSI, Elsevier, GE Healthcare, and Medtronic; research support from Siemens, Regeneron, and Osprey. Shareholder: MHI Ventures. Board of Trustees: Society of Cardiovascular Angiography and Interventions. Funding The author(s) disclosed receipt of the following financial support for the research and/or authorship of this article: The Progress CTO registry has received support from the Abbott Northwestern Hospital Foundation, Minneapolis, MN. ORCID iDs Iosif Xenogiannis https://orcid.org/0000-0002-5004-6635 Emmanouil S. Brilakis https://orcid.org/0000-0001-9416-9701 Publisher Copyright: © The Author(s) 2019.

PY - 2020/3/1

Y1 - 2020/3/1

N2 - The impact of peripheral artery disease (PAD) in patients undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. We reviewed 3999 CTO PCIs performed in 3914 patients between 2012 and 2018 at 25 centers, 14% of whom had a history of PAD. We compared the clinical and angiographic characteristics and procedural outcomes of patients with versus without history of PAD. Patients with PAD were older (67 ± 9 vs 64 ± 10 years, P <.001) and had a higher prevalence of cardiovascular risk factors. They also had more complex lesions as illustrated by higher Japanese CTO score (2.7 ± 1.2 vs 2.4 ± 1.3, P <.001). In patients with PAD, the final crossing technique was less often antegrade wire escalation (40% vs 51%, P <.001) and more often the retrograde approach (23 vs 20%, P <.001) and antegrade dissection/reentry (20% vs 16%, P <.001). Technical success was similar between the 2 study groups (84% vs 87%, P =.127), but procedural success was lower for patients with PAD (81% vs 85%, P =.015). The incidence of in-hospital major adverse cardiac events was higher among patients with PAD (3% vs 2%, P =.046). In conclusion, patients with PAD undergoing CTO PCI have more comorbidities, more complex lesions, and lower procedural success.

AB - The impact of peripheral artery disease (PAD) in patients undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. We reviewed 3999 CTO PCIs performed in 3914 patients between 2012 and 2018 at 25 centers, 14% of whom had a history of PAD. We compared the clinical and angiographic characteristics and procedural outcomes of patients with versus without history of PAD. Patients with PAD were older (67 ± 9 vs 64 ± 10 years, P <.001) and had a higher prevalence of cardiovascular risk factors. They also had more complex lesions as illustrated by higher Japanese CTO score (2.7 ± 1.2 vs 2.4 ± 1.3, P <.001). In patients with PAD, the final crossing technique was less often antegrade wire escalation (40% vs 51%, P <.001) and more often the retrograde approach (23 vs 20%, P <.001) and antegrade dissection/reentry (20% vs 16%, P <.001). Technical success was similar between the 2 study groups (84% vs 87%, P =.127), but procedural success was lower for patients with PAD (81% vs 85%, P =.015). The incidence of in-hospital major adverse cardiac events was higher among patients with PAD (3% vs 2%, P =.046). In conclusion, patients with PAD undergoing CTO PCI have more comorbidities, more complex lesions, and lower procedural success.

KW - chronic total occlusion

KW - percutaneous coronary intervention

KW - peripheral artery disease

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DO - 10.1177/0003319719895178

M3 - Article

C2 - 31845593

AN - SCOPUS:85077371805

SN - 0003-3197

VL - 71

SP - 274

EP - 280

JO - Angiology

JF - Angiology

IS - 3

ER -

The Impact of Peripheral Artery Disease in Chronic Total Occlusion Percutaneous Coronary Intervention (Insights From PROGRESS-CTO Registry)

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