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Published on: December 16, 2022

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In-hospital and long-term outcomes after percutaneous coronary intervention for chronic total occlusion in elderly

Romain André1, Nicolas Dumonteil1, Thibault Lhermusier1

  • 1Cardiology Department, Rangueil University Hospital, 31059 Toulouse cedex 9, France.

Archives of Cardiovascular Diseases
|October 29, 2015
PubMed

Insights

Percutaneous coronary interventions for chronic total occlusion (CTO-PCI) are feasible and safe in elderly patients. Successful CTO-PCI improves long-term survival, offering a valuable treatment option for this population.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Geriatric Cardiology

Background:

  • Elderly patients increasingly undergo complex percutaneous coronary interventions (PCI), including chronic total occlusion (CTO) recanalization.
  • CTO-PCI is a challenging procedure, and its feasibility and safety in the elderly population require careful evaluation.

Purpose of the Study:

  • To assess the feasibility, safety, and clinical benefits of CTO-PCI in elderly patients (≥ 75 years).
  • To compare outcomes between elderly and younger patients undergoing CTO-PCI.
  • To evaluate the long-term clinical effect of successful CTO recanalization in elderly patients.

Main Methods:

  • Prospective inclusion of 356 consecutive patients undergoing CTO-PCI (January 2008 - December 2011).
  • Comparison of procedural success and postoperative complications between patients aged ≥ 75 years (n=93) and < 75 years.
  • 20-month follow-up analysis of clinical outcomes in elderly patients post-successful recanalization.

Main Results:

  • Procedural success rates were similar between elderly (78.2%) and younger (74.3%) patients.
  • Postoperative complications were significantly higher in older patients (5.4% vs. 0.4%, P=0.005).
  • Successful revascularization in elderly patients was associated with improved 20-month event-free survival (HR: 0.43, P=0.039).

Conclusions:

  • Elderly patients present with more complex coronary artery disease and face higher risks of postoperative complications.
  • CTO-PCI demonstrates similar success rates in elderly and younger patients.
  • Successful CTO recanalization in selected elderly patients is a viable strategy that improves long-term prognosis.
Abstract

Keywords:
AgeAngioplastieChronic total occlusionOcclusion coronaire chroniqueOutcomesPercutaneous coronary interventionPronosticÂgés

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