دورية أكاديمية
أعرض في EDS

Prevalence and Outcomes of Percutaneous Coronary Interventions for Ostial Chronic Total Occlusions: Insights From a Multicenter Chronic Total Occlusion Registry.

التفاصيل البيبلوغرافية
العنوان: Prevalence and Outcomes of Percutaneous Coronary Interventions for Ostial Chronic Total Occlusions: Insights From a Multicenter Chronic Total Occlusion Registry.
المؤلفون: Tajti P; Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA; University of Szeged, Division of Invasive Cardiology, Department of Second Internal Medicine and Cardiology Center, Szeged, Hungary., Burke MN; Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA., Karmpaliotis D; Columbia University, New York, New York, USA., Alaswad K; Henry Ford Hospital, Detroit, Michigan, USA., Jaffer FA; Massachusetts General Hospital, Boston, Massachusetts, USA., Yeh RW; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA., Patel M; VA San Diego Healthcare System and University of California San Diego, La Jolla, California, USA., Mahmud E; VA San Diego Healthcare System and University of California San Diego, La Jolla, California, USA., Choi JW; Baylor Heart and Vascular Hospital, Dallas, Texas, USA., Doing AH; Medical Center of the Rockies, Loveland, Colorado, USA., Datilo P; Medical Center of the Rockies, Loveland, Colorado, USA., Toma C; University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA., Smith AJC; University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA., Uretsky B; VA Central Arkansas Healthcare System, Little Rock, Arkansas, USA., Holper E; The Heart Hospital Baylor Plano, Plano, Texas, USA., Garcia S; VA Minneapolis Healthcare System and University of Minnesota, Minneapolis, Minnesota, USA., Krestyaninov O; Meshalkin Siberian Federal Biomedical Research Center, Ministry of Health of Russian Federation, Novosibirsk, Russian Federation., Khelimskii D; Meshalkin Siberian Federal Biomedical Research Center, Ministry of Health of Russian Federation, Novosibirsk, Russian Federation., Koutouzis M; Korgialeneio-Benakeio Hellenic Red Cross General Hospital of Athens, Athens, Greece., Tsiafoutis I; Korgialeneio-Benakeio Hellenic Red Cross General Hospital of Athens, Athens, Greece., Moses JW; Columbia University, New York, New York, USA., Lembo NJ; Columbia University, New York, New York, USA., Parikh M; Henry Ford Hospital, Detroit, Michigan, USA., Kirtane AJ; Henry Ford Hospital, Detroit, Michigan, USA., Ali ZA; Columbia University, New York, New York, USA., Doshi D; Columbia University, New York, New York, USA., Jaber W; Emory University Hospital Midtown, Atlanta, Georgia, USA., Samady H; Emory University Hospital Midtown, Atlanta, Georgia, USA., Rangan BV; VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas, USA., Xenogiannis I; Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA., Ungi I; University of Szeged, Division of Invasive Cardiology, Department of Second Internal Medicine and Cardiology Center, Szeged, Hungary., Banerjee S; VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas, USA., Brilakis ES; Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA. Electronic address: esbrilakis@gmail.com.
المصدر: The Canadian journal of cardiology [Can J Cardiol] 2018 Oct; Vol. 34 (10), pp. 1264-1274. Date of Electronic Publication: 2018 Jul 31.
نوع المنشور: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: England NLM ID: 8510280 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1916-7075 (Electronic) Linking ISSN: 0828282X NLM ISO Abbreviation: Can J Cardiol Subsets: MEDLINE
أسماء مطبوعة: Publication: Jan./Feb. 2011- : Oxford, UK : Elsevier
Original Publication: [Oakville, Ont. : Canadian Cardiology Publications Inc., c1984-
مواضيع طبية MeSH: Registries*, Coronary Occlusion/*surgery , Percutaneous Coronary Intervention/*statistics & numerical data, Chronic Disease ; Coronary Angiography ; Coronary Occlusion/diagnosis ; Coronary Occlusion/epidemiology ; Europe/epidemiology ; Female ; Hospital Mortality/trends ; Humans ; Male ; Prevalence ; Risk Factors ; Time Factors ; Treatment Outcome ; United States/epidemiology
مستخلص: Background: Ostial chronic total occlusions (CTOs) can be challenging to recanalize.
Methods: We sought to examine the prevalence, angiographic presentation, and procedural outcomes of ostial (side-branch ostial and aorto-ostial) CTOs among 1000 CTO percutaneous coronary interventions (PCIs) performed in 971 patients between 2015 and 2017 at 14 centres in the US, Europe, and Russia.
Results: Ostial CTOs represented 16.9% of all CTO PCIs: 9.6% were aorto-ostial, and 7.3% were side-branch ostial occlusions. Compared with nonostial CTOs, ostial CTOs were longer (44 ± 33 vs 29 ± 19 mm, P < 0.001) and more likely to have proximal-cap ambiguity (55% vs 33%, P < 0.001), moderate/severe calcification (67% vs 45%, P < 0.001), a diffusely diseased distal vessel (41% vs 26%, P < 0.001), interventional collaterals (64% vs 53%, P = 0.012), and previous coronary artery bypass graft surgery (CABG) (51% vs 27%, P < 0.001). The retrograde approach was used more often in ostial CTOs (54% vs 29%, P < 0.001) and was more often the final successful crossing strategy (30% vs 18%, P = 0.003). Technical (81% vs 84%, P = 0.280), and procedural (77% vs 83%, P = 0.112) success rates and the incidence of in-hospital major complication were similar (4.8% vs 2.2%, P = 0.108), yet in-hospital mortality (3.0% vs 0.5%, P = 0.010) and stroke (1.2% vs 0.0%, P = 0.030) were higher in the ostial CTO PCI group. In multivariable analysis, ostial CTO location was not independently associated with higher risk for in-hospital major complications (adjusted odds ratio 1.27, 95% confidence intervals 0.37 to 4.51, P = 0.694).
Conclusions: Ostial CTOs can be recanalized with similar rates of success as nonostial CTOs but are more complex, more likely to require retrograde crossing and may be associated with numerically higher risk for major in-hospital complications.
(Copyright © 2018 Canadian Cardiovascular Society. All rights reserved.)
التعليقات: Comment in: Can J Cardiol. 2018 Oct;34(10):1240-1243. (PMID: 30269820)
سلسلة جزيئية: ClinicalTrials.gov NCT02061436
تواريخ الأحداث: Date Created: 20181002 Date Completed: 20190606 Latest Revision: 20190606
رمز التحديث: 20240628
DOI: 10.1016/j.cjca.2018.07.472
PMID: 30269827
قاعدة البيانات: MEDLINE
الوصف
تدمد:1916-7075
DOI:10.1016/j.cjca.2018.07.472