Back to Search
Start Over
Emergency coronary artery bypass surgery after chronic total occlusion percutaneous coronary intervention: Insights from the PROGRESS-CTO registry.
- Source :
-
International journal of cardiology [Int J Cardiol] 2024 Jun 15; Vol. 405, pp. 131931. Date of Electronic Publication: 2024 Mar 02. - Publication Year :
- 2024
-
Abstract
- Background: Emergency coronary artery bypass surgery (eCABG) is a serious complication of chronic total occlusion (CTO) percutaneous coronary artery intervention (PCI).<br />Methods: We examined the incidence and outcomes eCABG among 14,512 CTO PCIs performed between 2012 and 2023 in a large multicenter registry.<br />Results: The incidence of eCABG was 0.12% (n = 17). Mean age was 68 ± 6 years and 69% of the patients were men. The most common reason for eCABG was coronary perforation (70.6%). eCABG patients had larger target vessel diameter (3.36 ± 0.50 vs. 2.90 ± 0.52; p = 0.003), were more likely to have moderate/severe calcification (85.7% vs. 45.8%; p = 0.006), side branch at the proximal cap (91.7% vs. 55.4%; p = 0.025), and balloon undilatable lesions (50% vs. 7.4%; p = 0.001) and to have undergone retrograde crossing (64.7% vs. 30.8%, p = 0.006). eCABG cases had lower technical (35.3% vs. 86.7%; p < 0.001) and procedural (35.3% vs. 86.7%; p < 0.001) success and higher in-hospital mortality (35.3% vs. 0.4%; p < 0.001), coronary perforation (70.6% vs. 4.6%; p < 0.001), pericardiocentesis (47.1% vs. 0.8%; p < 0.001), and major bleeding (11.8% vs. 0.5%; p < 0.001).<br />Conclusions: The incidence of eCABG after CTO PCI was 0.12% and associated with high in-hospital mortality (35%). Coronary perforation was the most common reason for eCABG.<br />Competing Interests: Declaration of competing interest Dr. Khatri: Personal Honoria for proctoring and speaking: Abbott Vascular, Medtronic, Terumo, Shockwave Medical. Dr. Jaffer has conducted sponsored research for Canon, Siemens, Shockwave, Teleflex, Mercator,Boston Scientific, HeartFlow, and Amarin; has served as a consul-tant for Boston Scientific, Siemens, Magenta Medical, International Medical Device Solutions, Asahi Intecc, Biotronik, Philips, Intravascular Imaging, and DurVena; owns equity interest in Intravascular Imaging Inc. and DurVena; and his employer, Massachusetts General Hospital, has licensing arrangements with Terumo, Canon, and Spectrawave for which he has the right to receive royalties. Dr. Davies: speaking honoraria from Abiomed, Asahi Intec, Boston Sci, Medtronic, Shockwave and Teleflex. She also serves on advisory boards for Abiomed, Avinger, Boston Sci, Medtronic and Rampart. Dr. Patel has received consulting honoraria from Abbott, Medtronic, Terumo, and Cardiovascular Systems. Dr. Sandoval: consulting/speaker honoraria from Abbott Diagnostics, Roche Diagnostics, Zoll, Philips. JACC Advances associate editor. Patent 20,210,401,347. Dr. Burke: consulting and received speaker honoraria from Abbott Vascular and Boston Scientific. Dr. Brilakis: consulting/speaker honoraria from Abbott Vascular, American Heart Association (associate editor Circulation), Biotronik, Boston Scientific, Cardiovascular Innovations Foundation (Board of Directors), CSI, Elsevier, GE Healthcare, IMDS, Medtronic, and Teleflex; research support: Boston Scientific, GE Healthcare; owner, Hippocrates LLC; shareholder: MHI Ventures, Cleerly Health, Stallion Medical.<br /> (Copyright © 2024. Published by Elsevier B.V.)
- Subjects :
- Humans
Male
Aged
Female
Middle Aged
Chronic Disease
Postoperative Complications epidemiology
Postoperative Complications etiology
Incidence
Hospital Mortality trends
Treatment Outcome
Emergencies
Coronary Occlusion surgery
Coronary Occlusion epidemiology
Registries
Percutaneous Coronary Intervention adverse effects
Percutaneous Coronary Intervention methods
Percutaneous Coronary Intervention trends
Coronary Artery Bypass adverse effects
Coronary Artery Bypass trends
Subjects
Details
- Language :
- English
- ISSN :
- 1874-1754
- Volume :
- 405
- Database :
- MEDLINE
- Journal :
- International journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 38432608
- Full Text :
- https://doi.org/10.1016/j.ijcard.2024.131931