Acute outcome of chronic total occlusion (CTO) recanalizsation in the elderly
J E Guelker1, T Rock2, R Ott2
1Helios Clinic Krefeld, Department of Cardiology, Heartcentre Niederrhein, Germany. jan-erik.guelker@helios-kliniken.de.
Insights
Age does not impact the success or safety of percutaneous coronary intervention (PCI) for chronic total occlusions (CTO). This interventional therapy is safe and feasible for older patients with severe coronary artery disease.
Area of Science:
- Interventional Cardiology
- Cardiovascular Disease Research
Background:
- Percutaneous coronary intervention (PCI) for chronic total occlusions (CTO) presents significant challenges in interventional cardiology.
- Limited data exists regarding age-related differences in CTO recanalization outcomes.
Purpose of the Study:
- To investigate the impact of patient age on procedural characteristics, complications, and short-term outcomes of CTO PCI.
- To assess the feasibility and safety of CTO PCI across different age groups.
Main Methods:
- A cohort of 440 patients undergoing PCI for at least one CTO between 2012-2016 was analyzed.
- Both antegrade and retrograde CTO techniques were employed, with retrograde used after failed antegrade attempts.
- Statistical analysis included t-tests to compare variables between age cohorts.
Main Results:
- Procedural success for CTO PCI was found to be independent of patient age (p=0.5).
- Complication rates were low and statistically similar between age groups (2.7% vs. 4%).
Conclusions:
- CTO PCI is a safe and feasible interventional therapy, even for older patients.
- Increased utilization of CTO PCI is recommended in an aging population with severe coronary artery disease and CTOs.
Objectives:
Percutaneous coronary intervention (PCI) of total chronic total occlusion (CTO) still remains a major challenge in interventional cardiology. There is only insignificant knowledge reported in the literature about age differences in CTO recanalization. We analyzed in this study the issue of the impact of age on procedural characteristics, complications and short-term outcome.
Methods:
Between 2012-2016 we included 440 patients. They underwent PCI for at least one CTO. Antegrade and retrograde CTO techniques were applied. The retrograde approach was used only after failed antegrade intervention. Continuous data are presented as the mean ± standard deviation; categorical data are presented as numbers and percentages unless otherwise specified. We used Twosamplet- t-test with equal variance to test the significant differences of the variables between the two cohorts.
Results:
Procedural success proved independently of age. There was no significant interaction between age and procedural success (p=0.5). Complication rates were low in both groups (2.7% vs. 4%; p=0,4) with no difference in statistical significance.
Conclusions:
Our study suggests that in an aging society patients with severe coronary artery disease and chronical total occlusions an interventional therapy should be used more intensively. It can be performed safe and feasible.
