Usefulness of Atherectomy in Chronic Total Occlusion Interventions (from the PROGRESS-CTO Registry)

There is limited data on the use of atherectomy during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We compared the clinical and procedural characteristics and outcomes of CTO PCIs performed with or without atherectomy in a contemporary multicenter CTO PCI registry. Betwee...

Teljes leírás

Elmentve itt :
Bibliográfiai részletek
Szerzők: Xenogiannis Iosif
Karmpaliotis Dimitri
Alaswad Khaldoon
Jaffer Farouc A.
Yeh Robert W.
Patel Mitul
Mahmud Ehtisham
Choi James W.
Burke M Nicholas
Doing Anthony H.
Dattilo Phil
Toma Catalin
Smith Conrad A. J.
Uretsky Barry
Tajti Péter
Dokumentumtípus: Cikk
Megjelent: 2019
Sorozat:AMERICAN JOURNAL OF CARDIOLOGY 123 No. 9
Tárgyszavak:
doi:10.1016/j.amjcard.2019.01.054

mtmt:30594199
Online Access:http://publicatio.bibl.u-szeged.hu/23457
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520 3 |a There is limited data on the use of atherectomy during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We compared the clinical and procedural characteristics and outcomes of CTO PCIs performed with or without atherectomy in a contemporary multicenter CTO PCI registry. Between 2012 and 2018, 3,607 CTO PCIs were performed at 21 participating centers. Atherectomy was used in 117 (3.2%) cases: rotational atherectomy in 105 cases, orbital atherectomy in 8, and both in 4 cases. Patients in whom atherectomy was used, were older (68 ± 8 vs 64 ± 10 years, p <0.0001) and had higher Japan-chronic total occlusion score (3.0 ± 1.2 vs 2.4 ± 1.3, p <0.0001). CTO PCI cases in which atherectomy was used had similar technical (91% vs 87%, p = 0.240) and procedural (90% vs 85%, p = 0.159) success and in-hospital major adverse cardiac event (4% vs 3%, p = 0.382) rates. However, atherectomy cases were associated with higher rates of donor vessel injury (4% vs 1%, p = 0.031), tamponade requiring pericardiocentesis (2.6% vs 0.4%, p = 0.012) and more often required use of a left ventricular assist device (9% vs 5%, p = 0.031). Atherectomy cases were associated with longer procedural duration (196 [141, 247] vs 119 [76, 180] minutes, p <0.0001), and higher patient air kerma radiation dose (3.6 [2.5, 5.6] vs 2.8 [1.6, 4.7] Gray, p = 0.001). In conclusion, atherectomy is currently performed in approximately 3% of CTO PCI cases and is associated with similar technical and procedural success and overall major adverse cardiac event rates, but higher risk for donor vessel injury and tamponade. 
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700 0 1 |a Karmpaliotis Dimitri  |e aut 
700 0 1 |a Alaswad Khaldoon  |e aut 
700 0 1 |a Jaffer Farouc A.  |e aut 
700 0 1 |a Yeh Robert W.  |e aut 
700 0 1 |a Patel Mitul  |e aut 
700 0 1 |a Mahmud Ehtisham  |e aut 
700 0 1 |a Choi James W.  |e aut 
700 0 1 |a Burke M Nicholas  |e aut 
700 0 1 |a Doing Anthony H.  |e aut 
700 0 1 |a Dattilo Phil  |e aut 
700 0 1 |a Toma Catalin  |e aut 
700 0 1 |a Smith Conrad A. J.  |e aut 
700 0 1 |a Uretsky Barry  |e aut 
700 0 1 |a Tajti Péter  |e aut 
856 4 0 |u http://publicatio.bibl.u-szeged.hu/23457/1/AmJCardXenogiannis.pdf  |z Dokumentum-elérés