Outcomes of Percutaneous Antegrade Intraluminal Coronary Intervention of Chronic Total Occlusion With Remote Surgical...

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Medicine

Background:

• Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) is often avoided in centers without immediate surgical support.
• Remote surgical backup presents a potential alternative for performing complex CTO interventions.

Purpose of the Study:

• To evaluate the feasibility and outcomes of antegrade intraluminal CTO PCI performed with remote surgical backup.
• To assess the safety and efficacy of CTO PCI in a non-surgical backup setting.

Main Methods:

• Retrospective analysis of patients undergoing attempted antegrade intraluminal CTO PCI between January 2013 and July 2017.
• Data collected included procedural success, complications, and clinical outcomes at short-term and long-term follow-up.

Main Results:

• Eighty-five percent (17 of 20) of CTO PCI procedures were successful.
• Low rates of procedural complications were observed, including non-flow limiting dissections and wire perforation.
• No cardiac deaths, myocardial infarctions, target vessel revascularizations, or strokes occurred within 30 days or at a mean follow-up of 19.5 months.

Conclusions:

• Careful antegrade intraluminal CTO intervention can be safely and effectively performed in selected patients at centers with remote surgical backup.
• This approach expands the accessibility of CTO PCI for patients who might otherwise not be candidates.