1. Procedural, Functional and Prognostic Outcomes Following Recanalization of Coronary Chronic Total Occlusions. Results of the Iberian Registry.
- Author
-
Amat-Santos IJ, Martin-Yuste V, Fernández-Díaz JA, Martin-Moreiras J, Caballero-Borrego J, Salinas P, Ojeda S, Rivero F, Núñez Villota J, Mohandes M, Dubois D, Bosa Ojeda F, Rumiz E, de la Torre Hernández JM, Jiménez-Mazuecos J, Lacunza J, Tejedor P, Gómez I, Goncalves-Ramirez LR, Rojas P, Sabaté M, Goicolea J, Diego Nieto A, Jiménez-Fernández M, Escaned J, Gonzalo N, Pardo L, Cuesta J, Miñana G, Sanchis J, Rojas S, Millán R, Vaquerizo B, Rodríguez S, Lee DH, Morales FJ, Gutiérrez A, López M, Maristany J, Rondán J, Galeote G, Kabbanni Z, Rodríguez S, Teruel L, Sadaba M, Jurado A, Mainar V, Sánchez-Rubio J, Vinhas H, and Fernandes R
- Subjects
- Aged, Chronic Disease, Coronary Occlusion mortality, Female, Humans, Male, Myocardial Ischemia etiology, Myocardial Ischemia mortality, Myocardial Ischemia surgery, Myocardial Revascularization statistics & numerical data, Percutaneous Coronary Intervention methods, Percutaneous Coronary Intervention statistics & numerical data, Portugal epidemiology, Postoperative Complications etiology, Postoperative Complications mortality, Prospective Studies, Registries, Reoperation statistics & numerical data, Spain epidemiology, Surgery, Computer-Assisted methods, Treatment Outcome, Ultrasonography, Interventional methods, Coronary Occlusion surgery, Myocardial Revascularization methods
- 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 ≤ 2 (80.5% vs 69.5%; P = .002), and in intravascular ultrasound-guided PCI (89.9% vs 76.2%, P = .001), which was an independent predictor of success. In contrast, severe calcification, length > 20mm, 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., (Copyright © 2018. Published by Elsevier España, S.L.U.)
- Published
- 2019
- Full Text
- View/download PDF