1. Chronic total occlusion percutaneous coronary intervention in Latin America
- Author
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Sandra Baradel, Anibal P. Abelin, Luis A Perez, Ramiro C Degrazia, Felipe Costa Fuchs, Marcelo José de Carvalho Cantarelli, Pedro Piccaro de Oliveira, Mario Araya, Luiz F. Ybarra, Cristiano Guedes Bezerra, José Armando Mangione, Pablo Lamelas, Evandro Martins Filho, José A. Navarro Lecaro, Fabio Sandoli de Brito, Daniel Weilenmann, Silvio Gioppato, Joao De Paula, Viviana de Mello Guzzo Lemke, Ricardo Santiago, Carlos M. Campos, Alexandre Schaan de Quadros, Lucio Padilla, Marco Alcantara, Antonio Carlos Botelho da Silva, Gustavo C Martinelli, Leandro A Côrtes, Karlyse Claudino Belli, Félix Damas de los Santos, Franklin Hanna Quesada, Breno de Alencar Araripe Falcão, Pedro Beraldo de Andrade, Antônio José Muniz, Marcelo Harada Ribeiro, Cesar R. Medeiros, Cleverson N Zukowski, and Carlos A. M. Gottschall
- Subjects
Male ,medicine.medical_specialty ,Percutaneous ,Time Factors ,medicine.medical_treatment ,Myocardial Infarction ,030204 cardiovascular system & hematology ,Coronary Angiography ,Risk Assessment ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Percutaneous Coronary Intervention ,Risk Factors ,Cardiac tamponade ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,030212 general & internal medicine ,Hospital Mortality ,Registries ,Aged ,business.industry ,Incidence (epidemiology) ,Percutaneous coronary intervention ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,Stroke ,Dissection ,Latin America ,Treatment Outcome ,Coronary Occlusion ,Conventional PCI ,Chronic Disease ,Female ,Cardiology and Cardiovascular Medicine ,business ,Mace - Abstract
Objectives To report clinical, angiographic characteristics, outcomes, and predictors of unsuccessful procedures in patients who underwent chronic total occlusion (CTO) percutaneous coronary interventions (PCI) in Latin America. Background CTO PCI has been increasingly performed worldwide, but there is a lack of information in this region. Methods An international multicenter registry was developed to collect data on CTO PCI performed in centers in Latin America. Patient, angiographic, procedural and outcome data were evaluated. Predictors of unsuccessful procedures were assessed by multivariable analysis. Results We have included data related to 1,040 CTO PCIs performed in seven countries in Latin America (Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, and Puerto Rico). The mean age was 64 ± 10 years, and CTO PCI was performed mainly for angina control (81%) or treatment of a large ischemic area (30%). Overall technical success rate was 82.5%, and it was achieved with antegrade wire escalation in 81%, antegrade dissection/re-entry in 8% and with retrograde techniques in 11% of the successful procedures. Multivariable analysis identified moderate/severe calcification, a blunt proximal cap and a previous attempt as independent predictors of unsuccessful procedures. In-hospital major adverse cardiovascular events (MACE) occurred in 3.1% of the cases, death in 1% and cardiac tamponade in 0.9% CONCLUSIONS: CTO PCI in Latin America has been performed mainly for ischemia relief. Procedures were associated with a success rate above 80% and low incidence of MACE. Predictors of unsuccessful procedures were similar to those previously reported in the literature.
- Published
- 2019