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D A Khelimskii1, O V Krestyaninov, A G Badoyan

  • 1National Medical Research Center named after acad. E. N. Meshalkin.. dkhelim@mail.ru.

Kardiologiia
|March 12, 2019
PubMed
Summary

Percutaneous coronary intervention (PCI) for chronic total occlusions (CTO) in ischemic heart disease (IHD) showed low adverse events. However, success rates for CTO PCI require improvement through dedicated algorithms.

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Chronic total occlusions (CTO) are a significant challenge in patients with ischemic heart disease (IHD).
  • Percutaneous coronary intervention (PCI) using contemporary endovascular techniques offers a revascularization option for CTO.
  • Assessing the procedural and in-hospital outcomes of CTO PCI is crucial for optimizing patient care.

Purpose of the Study:

  • To evaluate the outcomes of percutaneous coronary intervention (PCI) for chronic total coronary artery occlusions (CTO) in patients with ischemic heart disease (IHD).
  • To analyze procedural success and complication rates associated with contemporary endovascular techniques for CTO recanalization.

Main Methods:

  • Retrospective analysis of 456 patients undergoing 477 CTO PCI procedures between 2014-2016.
  • CTO locations included right (61.2%), LAD (23.2%), and circumflex (15.3%) arteries; J-CTO scores categorized lesion complexity.
  • Antegrade and retrograde approaches were utilized, with radial artery access being most common.

Main Results:

  • Technical and procedural success rates were 78.4% and 76.7%, respectively.
  • Antegrade approach was predominant (79.2%), while retrograde was used in 20.7% of cases.
  • Mean fluoroscopy time was 36.2±31 minutes, with an average of 1.6±0.98 stents per lesion.

Conclusions:

  • Procedural adverse events for CTO PCI were low and comparable to non-CTO PCI procedures.
  • Despite advancements, CTO PCI success rates in this cohort were lower than in specialized centers, indicating a need for improvement.
  • Development and implementation of a dedicated CTO recanalization algorithm may enhance procedural success rates.

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