Percutaneous coronary intervention in aorto-ostial coronary chronic total occlusion: outcomes and technical considerations in a multicenter registry.
In: Revista espanola de cardiologia (English ed.), Jg. 73 (2020-12-01), Heft 12, S. 1011-1017
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Zugriff:
Introduction and Objectives: Percutaneous coronary intervention (PCI) for aorto-ostial chronic total coronary occlusion (CTO) can be a particularly challenging lesion subset. The aim of this study was to analyze the technical aspects and outcomes of aorto-ostial CTO PCI in a multicenter registry.
Methods: Patients undergoing aorto-ostial CTO PCI at 4 centers between February 2013 and December 2018 were included. Success rates, as well as procedural aspects and outcomes, were analyzed.
Results: A total of 103 patients were included. Mean age was 64±10 years and the mean J-CTO score was 3.1±1.1. Thirty-one lesions (30.4%) were flush ostial CTOs. Technical and procedural success were achieved in 79 (76.7%) and 78 (75.7%) of the patients, respectively. The retrograde approach was the most frequent successful crossing technique (n=49; 62.0%), especially in flush vs nonflush aorto-ostial CTOs (82.6% vs 53.5%; P=.02). The only variable independently associated with technical failure was the absence of interventional collaterals (OR, 12.38; 95%CI, 4.02-38.15; P <.001). Coronary perforation occurred in 4 patients (3.9%) requiring covered stent implantation (without subsequent cardiac tamponade) and 2 patients (1.9%) had a stroke (one of which was a transient ischemic attack). During a median follow-up of 31 months, 3 (2.9%) patients died from cardiovascular causes and 13 (12.6%) required repeat target vessel revascularization.
Conclusions: Aorto-ostial occlusions represent a challenging subset for PCI. However, an acceptable success rate with favorable outcomes during follow-up can be achieved by experienced operators. The presence of interventional collaterals allowing the use of the retrograde approach is key for achieving procedural success.
(Copyright © 2020 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)
Titel: |
Percutaneous coronary intervention in aorto-ostial coronary chronic total occlusion: outcomes and technical considerations in a multicenter registry.
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Autor/in / Beteiligte Person: | Ojeda, S ; Luque, A ; Pan, M ; Bellini, B ; Xenogiannis, I ; Lostalo, A ; Montorfano, M ; Hidalgo, F ; Venuti, G ; La Manna, A ; Carlino, M ; Brilakis, ES ; Azzalini, L |
Zeitschrift: | Revista espanola de cardiologia (English ed.), Jg. 73 (2020-12-01), Heft 12, S. 1011-1017 |
Veröffentlichung: | Barcelona : Elsevier Doyma, 2020 |
Medientyp: | academicJournal |
ISSN: | 1885-5857 (electronic) |
DOI: | 10.1016/j.rec.2020.01.008 |
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