Abstract 11349: Impact of Concomitant Treatment of Non-Chronic Total Occlusion Lesions at the Time of Chronic Total Occlusion Intervention: Insights From the Progress-CTO Registry.

Background: Occasionally during chronic total occlusion (CTO) percutaneous coronary intervention (PCI) non-CTO lesions are also treated. We sought to examine the impact of non-CTO PCI when performed at the time of CTO PCI. Methods: We compared the clinical and procedural characteristics and outcomes of CTO PCIs with and without concomitant treatment of non-CTO lesion in a contemporary multicenter CTO registry. Results: Of the 3,598 CTO PCIs performed at 21 centers between 2012 and 2018, 817 (22.7%) also included PCI of non-CTO lesion. Patients in whom non-CTO lesions were treated were older (65 ± 10 vs. 64 ± 10 years, p=0.024), more likely to present with an acute coronary syndrome (32% vs. 23%, p<0.0001), and less likely to undergo PCI of a right coronary artery CTO (46% vs. 58%, p<0.0001). The most common non-CTO lesion location was the left anterior descending artery (31%), followed by left circumflex (29%) and right coronary artery (25%). CTO lesions in patients who underwent both CTO and non-CTO PCI at the same procedure had lower J-CTO score (2.3±1.3 vs. 2.4±1.3, p=0.04). Combined non-CTO and CTO-PCI procedures had similar technical (88% vs. 87%, p=0.315) and procedural (86% vs. 85%, p=0.670) success and major in-hospital complication rates (MACE) (3.4% vs. 2.7%, p=0.232) (Figure), but had longer duration (155±99 vs. 136±82 minutes, p<0.0001), higher patient air kerma radiation dose (3.6±2.3 vs. 3.3± 2.4 Gray, p=0.016) and larger contrast volume (314±136 vs. 273±130 ml, p<0.0001) compared with CTO PCI only procedures. Conclusions: Combined CTO PCI with PCI of non-CTO lesions is associated with similar success and major in-hospital complication rates compared with cases in which only CTOs were treated, but at the expense of longer procedure duration and higher radiation dose and contrast volume. [ABSTRACT FROM AUTHOR]