1. Procedural, Functional and Prognostic Outcomes Following Recanalization of Coronary Chronic Total Occlusions. Results of the Iberian Registry
- Author
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Laura Pardo, Luis Teruel, Francisco Bosa Ojeda, Beatriz Vaquerizo, Fernando Rivero, Alfonso Jurado, Sara Rodríguez, Victoria Martin-Yuste, Mario Sadaba, Sergio Rojas, Juan Sanchis, Nieves Gonzalo, Dae-Hyun Lee, Hugo Vinhas, Manel Sabaté, Gema Miñana, Vicente Mainar, Juan Caballero-Borrego, Sergio Rodríguez, Renato Fernandes, Mohsen Mohandes, Daniela Dubois, Luis R. Goncalves-Ramírez, Miriam Jiménez-Fernández, Guillermo Galeote, Itziar Gómez, María José López, Javier Lacunza, Jaume Maristany, José M. de la Torre Hernández, Alejandro Gutiérrez, Javier Cuesta, Francisco J. Morales, Juan Sánchez-Rubio, Soledad Ojeda, Juan Rondan, Alejandro Diego Nieto, José Antonio Fernández-Díaz, Eva Rumiz, Pablo Salinas, Paula Tejedor, Julio Núñez Villota, Paol Rojas, Raúl Millán, Javier Martín-Moreiras, Zuheir Kabbanni, Javier Goicolea, Jesús Jiménez-Mazuecos, Ignacio J. Amat-Santos, and Javier Escaned
- Subjects
Male ,Reoperation ,medicine.medical_specialty ,Percutaneous ,medicine.medical_treatment ,Perforation (oil well) ,Myocardial Ischemia ,030204 cardiovascular system & hematology ,03 medical and health sciences ,Percutaneous Coronary Intervention ,Postoperative Complications ,0302 clinical medicine ,Internal medicine ,Myocardial Revascularization ,medicine ,Humans ,Prospective Studies ,Registries ,Myocardial infarction ,Prospective cohort study ,Ultrasonography, Interventional ,Aged ,Portugal ,business.industry ,Mortality rate ,Percutaneous coronary intervention ,General Medicine ,medicine.disease ,Treatment Outcome ,Coronary Occlusion ,Surgery, Computer-Assisted ,Spain ,Coronary occlusion ,Chronic Disease ,Conventional PCI ,Cardiology ,Female ,CTO, Cardiopatía isquémica crónica, Chronic ischemic cardiomyopathy, Chronic total occlusions, IVUS, OCT, Oclusiones crónicas ,business - Abstract
Introduction and objectives: There is current controversy regarding the benefits of percutaneous recanalization (PCI) of chronic total coronary occlusions (CTO). Our aim was to determine acute and follow-up outcomes in our setting. Methods: Two-year prospective registry of consecutive patients undergoing PCI of CTO in 24 centers. Results: A total of 1000 PCIs of CTO were performed in 952 patients. Most were symptomatic (81.5%), with chronic ischemic heart disease (59.2%). Previous recanalization attempts had been made in 15%. The mean SYNTAX score was 19.5 +/- 10.6 and J-score was > 2 in 17.3%. A retrograde procedure was performed in 92 patients (9.2%). The success rate was 74.9% and was higher in patients without previous attempts (82.2% vs 75.2%; P = .001), those with a J-score 20 mm, and blunt proximal cap were independent predictors of failed recanalization. The rate of procedural complications was 7.1%, including perforation (3%), myocardial infarction (1.3%), and death (0.5%). At 1-year of follow-up, 88.2% of successfully revascularized patients showed clinical improvement (vs 34.8%, P < .001), which was associated with lower mortality. At 1-year of follow-up, the mortality rate was 1.5%. Conclusions: Compared with other national registries, patients in the Iberian registry undergoing PCI of a CTO showed similar complexity, success rate, and complications. Successful recanalization was strongly associated with functional improvement, which was related to lower mortality. (C) 2018 Published by Elsevier Espana, S.L.U. on behalf of Sociedad Espanola de Cardiologia.
- Published
- 2019