Related Experiment Video
Updated: Apr 7, 2026
Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
Published on: September 22, 2020
Predictive factors and clinical outcomes following contemporary percutaneous coronary interventions for chronic total
Li Jin1, Chen Youhu1, Wang Huan1
1Department of Cardiology, The First Affiliated Hospital of Air Force Military Medical University, Xi'an, China.
Insights
This study identified key factors predicting outcomes after chronic total occlusion percutaneous coronary intervention (CTO-PCI). Lower ejection fraction and higher residual SYNTAX scores predict major adverse cardiovascular events, while specific lesion characteristics and longer procedure times increase revascularization risk.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Medicine
Background:
- Chronic total occlusion percutaneous coronary intervention (CTO-PCI) is a complex procedure.
- Understanding predictive factors for clinical outcomes is crucial for patient management.
Purpose of the Study:
- To explore predictive factors for one-year clinical outcomes after contemporary CTO-PCI.
- To identify risk factors for major adverse cardiovascular events (MACE) and target vessel revascularization (TVR).
Main Methods:
- A consecutive series of patients undergoing CTO-PCI between January 2018 and December 2020 were analyzed.
- Primary endpoint was MACE (all-cause death, myocardial infarction) at 12 months.
- Secondary endpoint was TVR at 12 months.
Main Results:
- Of 871 patients, 3.4% experienced MACE and 4.6% required TVR at one year.
- Independent predictors for MACE included left ventricular ejection fraction (LVEF) <40% and residual SYNTAX score ≥12.
- Proximal ambiguity cap and increased guide-wire manipulation time were independent risk factors for TVR.
Conclusions:
- Contemporary CTO-PCI offers acceptable one-year outcomes with a low incidence of adverse events.
- Addressing proximal ambiguity cap and reducing guide-wire manipulation time may decrease TVR rates.
Background:
We aimed to explore the predictive factors and one-year clinical outcomes following contemporary percutaneous coronary intervention for chronic total occlusion lesions (CTO-PCI).
Methods:
Consecutive patients from January 2018 to December 2020 were enrolled. The primary endpoint was major adverse cardiovascular events (MACE), which included all-cause death and myocardial infarction, while target vessel revascularization (TVR) was defined as the secondary endpoint, all of which were measured at 12 months.
Results:
891 consecutive patients underwent 1,010 CTO PCIs. Of these 871 patients meeting the inclusion criteria accepted the index CTO PCI and 96.8% of these cases were available with one-year follow-up data (n = 843). The incidence of MACE was observed in 29 patients (3.4%), with all-cause death occurring in 22 cases (2.6%) and myocardial infarction in 7 cases (0.8%). TVR occurred in 39 patients (4.6%). The multivariate analysis for MACE indicated that LVEF < 40% (P = 0.001) and residual SYNTAX score ≥12 (P = 0.020) was identified as independent risk factors. Parallelly, proximal ambiguity cap (P = 0.008) and increased guide-wire manipulation time (P < 0.001) were independent risk factors for TVR.
Conclusion:
Patients deserve acceptable outcomes with a low incidence of adverse events after one year following contemporary CTO PCI. Strategies solving with proximal ambiguity cap and shortening guide-wire manipulation time are conducive to decreasing TVR.
More Related Videos
10:03Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
05:41Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control
Published on: December 16, 2022
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:27Coronary Artery Disease V: Interprofessional Care
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:27Peripheral Artery Disease III: Interprofessional Care
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:30Coronary Artery Disease III: Clinical Manifestations