The Hybrid Approach to Chronic Total Occlusion Percutaneous Coronary Intervention: Update From the PROGRESS CTO Registry.

Tajti, P ; Karmpaliotis, D ; et al.

In: JACC. Cardiovascular interventions, Jg. 11 (2018-07-23), Heft 14, S. 1325-1335

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Objectives: The aim of this study was to determine the techniques and outcomes of hybrid chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in a diverse group of patients and operators on 2 continents.

Background: CTO PCI has been evolving with constant improvement of equipment and techniques.

Methods: Contemporary outcomes of CTO PCI were examined by analyzing the clinical, angiographic, and procedural characteristics of 3,122 CTO interventions performed in 3,055 patients at 20 centers in the United States, Europe, and Russia.

Results: The mean age was 65 ± 10 years, and 85% of the patients were men, with high prevalence of diabetes (43%), prior myocardial infarction (46%), prior coronary artery bypass graft surgery (33%), and prior PCI (65%). The CTO target vessels were the right coronary artery (55%), left anterior descending coronary artery (24%), and left circumflex coronary artery (20%). The mean J-CTO (Multicenter Chronic Total Occlusion Registry of Japan) and PROGRESS CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) scores were 2.4 ± 1.3 and 1.3 ± 1.0, respectively. The overall technical and procedural success rate was 87% and 85%, respectively, and the rate of in-hospital major complications was 3.0%. The final successful crossing strategy was antegrade wire escalation in 52.0%, retrograde in 27.1%, and antegrade dissection re-entry in 20.9%; >1 crossing strategy was required in 40.9%. Median contrast volume, air kerma radiation dose, and procedure and fluoroscopy time were 270 ml (interquartile range: 200 to 360 ml), 2.9 Gy (interquartile range: 1.7 to 4.7 Gy), 123 min (interquartile range: 81 to 188 min) and 47 min (interquartile range: 29 to 77 min), respectively.

Conclusions: CTO PCI is currently being performed with high success and acceptable complication rates among various experienced centers in the United States, Europe, and Russia. (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention [PROGRESS CTO]; NCT02061436).

Titel:	The Hybrid Approach to Chronic Total Occlusion Percutaneous Coronary Intervention: Update From the PROGRESS CTO Registry.
Autor/in / Beteiligte Person:	Tajti, P ; Karmpaliotis, D ; Alaswad, K ; Jaffer, FA ; Yeh, RW ; Patel, M ; Mahmud, E ; Choi, JW ; Burke, MN ; Doing, AH ; Dattilo, P ; Toma, C ; Smith, AJC ; Uretsky, B ; Holper, E ; Wyman, RM ; Kandzari, DE ; Garcia, S ; Krestyaninov, O ; Khelimskii, D ; Koutouzis, M ; Tsiafoutis, I ; Moses, JW ; Lembo, NJ ; Parikh, M ; Kirtane, AJ ; Ali, ZA ; Doshi, D ; Rangan, BV ; Ungi, I ; Banerjee, S ; Brilakis, ES
Link:	Full Text Finder (Volltext)
Zeitschrift:	JACC. Cardiovascular interventions, Jg. 11 (2018-07-23), Heft 14, S. 1325-1335
Veröffentlichung:	New York : Elsevier, 2018
Medientyp:	academicJournal
ISSN:	1876-7605 (electronic)
DOI:	10.1016/j.jcin.2018.02.036
Schlagwort:	Aged Chronic Disease Coronary Angiography Coronary Occlusion diagnostic imaging Europe epidemiology Female Humans Male Middle Aged Percutaneous Coronary Intervention adverse effects Prevalence Radiography, Interventional Registries Time Factors Treatment Outcome United States epidemiology Coronary Occlusion therapy Percutaneous Coronary Intervention methods
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't Language: English [JACC Cardiovasc Interv] 2018 Jul 23; Vol. 11 (14), pp. 1325-1335. <i>Date of Electronic Publication: </i>2018 Apr 26. MeSH Terms: Coronary Occlusion / therapy ; Percutaneous Coronary Intervention / methods ; Aged ; Chronic Disease ; Coronary Angiography ; Coronary Occlusion / diagnostic imaging ; Europe / epidemiology ; Female ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention / adverse effects ; Prevalence ; Radiography, Interventional ; Registries ; Time Factors ; Treatment Outcome ; United States / epidemiology Comments: Comment in: JACC Cardiovasc Interv. 2018 Jul 23;11(14):1336-1339. (PMID: 29706509) Contributed Indexing: Keywords: chronic total occlusion; outcomes; percutaneous coronary intervention; techniques Molecular Sequence: ClinicalTrials.gov NCT02061436 Entry Date(s): Date Created: 20180501 Date Completed: 20191121 Latest Revision: 20191121 Update Code: 20240513

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