1. Differences in patients and lesion and procedure characteristics depending on the age of the coronary chronic total occlusion
- Author
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Krzysztof Bryniarski, Alfredo R. Galassi, Kambis Mashayekhi, Jarosław Wójcik, Kamil Fijorek, Gerald S. Werner, Roberto Garbo, Carlo Di Mario, David Hildick-Smith, Nicolas Boudou, Leszek Bryniarski, Nicolaus Reifart, George Sianos, Bryniarski K.L., Werner G.S., Mashayekhi K., Wojcik J., Hildick-Smith D., Sianos G., Galassi A.R., Garbo R., Mario C.D., Fijorek K., Boudou N., Reifart N., and Bryniarski L.
- Subjects
medicine.medical_specialty ,Multivariate analysis ,medicine.medical_treatment ,lcsh:Medicine ,030204 cardiovascular system & hematology ,Revascularization ,lesion characteristics ,Percutaneous coronary intervention ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Occlusion ,Medicine ,030212 general & internal medicine ,Lesion characteristic ,Adverse effect ,chronic total occlusion ,Original Paper ,business.industry ,percutaneous coronary intervention ,lcsh:R ,Collateral circulation ,medicine.anatomical_structure ,Cardiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
Introduction: Whether duration of chronic total occlusion (CTO) affects lesion and procedural characteristics remains largely unknown. Aim: To investigate whether CTO duration influences lesion characteristics and revascularization success. Material and methods: EuroCTO Registry data on patients who had CTO percutaneous coronary intervention between January 2015 and April 2017 were analyzed. Three groups were created based on occlusion age: 3 to 6 months (n = 1415), 7 to 12 months (n = 973), > 12 months (n = 1656). Results: Patients with greater CTO duration were older (63.0 (56.0–70.0); 63.0 (56.0–71.0); 66.0 (59.0–73.0) years respectively; p < 0.001), had more 3-vessel disease (32.2%; 30.9%; 46.1% respectively; p < 0.001) and more frequent prior coronary artery bypass grafting (8.2%; 9.9%; 29.4% respectively; p < 0.001). In multivariate analysis, occlusion duration was associated with moderate/ severe calcification (OR = 1.52; 95% CI: 1.28–1.80; p < 0.001), lesion length > 20 mm (OR 1.77; 95% CI 1.49–2.10; p < 0.001), and collateral circulation Werner type 2 (OR = 1.20; 95% CI: 1.01–1.43; p = 0.041). The CTO duration was associated with lower procedural success (OR for success 0.60; 95% CI: 0.46–0.79; p < 0.001). In multivariate analysis in-hospital adverse events did not differ according to duration of CTO. Conclusions: Coronary artery CTO duration is associated with greater extent of calcification, lesion length, development of collateral circulation and, most importantly, with lower procedural success.
- Published
- 2019