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Procedure failure of chronic total occlusion percutaneous coronary intervention in an algorithm driven contemporary Asia‐Pacific Chronic Total Occlusion Club (APCTO Club) multicenter registry
- Source :
- Catheterization and Cardiovascular Interventions. 93:1033-1038
- Publication Year :
- 2019
- Publisher :
- Wiley, 2019.
-
Abstract
- Objective With the evolution of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) technique and equipment, the success rate of CTO PCI has improved over the years. We examined the failed cases in this expert registry and looked at the mode of failure. Methods In 2016, consecutive CTO PCI performed by eight high volume CTO with an agreed CTO algorithm were examined in a registry. Results There was a total of 485 patients with 497 CTOs were treated with technical and procedural success rates of 93.8% and 89.9%, respectively. The mean J-CTO score was 2.9 ± 1.2. The main mode of failure in cases with only antegrade attempt was inability to wire to true lumen despite advanced antegrade wiring technique for example, parallel wiring or IVUS guided wiring (10 out of 11 cases). The mode of failure in retrograde attempt was: 30% was due to inability to wire the collateral channel; 30% was due to failed reverse controlled antegrade and retrograde subintimal tracking (CART); 30% was due to inability to cross CTO by retrograde microcatheter. Four cases were terminated prematurely due to procedure complications. Conclusion Similar to previous reported studies, primary failure mode of only antegrade attempt was inability to wire to true lumen. However, contrary to other registries where failure to cross the retrograde channel with wire was the predominant failure mode, the retrograde failure mode was equally divided between failure to cross the channel with wire, failure to do reverse CART, and failure to cross the CTO with the microcatheter.
- Subjects :
- Male
Asia
medicine.medical_treatment
Clinical Decision-Making
Technical failure
Lumen (anatomy)
030204 cardiovascular system & hematology
Coronary Angiography
Risk Assessment
Total occlusion
Decision Support Techniques
03 medical and health sciences
Percutaneous Coronary Intervention
0302 clinical medicine
Asia pacific
Predictive Value of Tests
Risk Factors
Humans
Medicine
Radiology, Nuclear Medicine and imaging
Registries
Treatment Failure
030212 general & internal medicine
Aged
business.industry
Australia
Percutaneous coronary intervention
Collateral channel
General Medicine
Middle Aged
Coronary Occlusion
Chronic Disease
Conventional PCI
Female
Cardiology and Cardiovascular Medicine
business
Algorithm
Algorithms
Subjects
Details
- ISSN :
- 1522726X and 15221946
- Volume :
- 93
- Database :
- OpenAIRE
- Journal :
- Catheterization and Cardiovascular Interventions
- Accession number :
- edsair.doi.dedup.....6329413aa59b5fd484c739c68bbce4f2