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Title: | Chronic Total Occlusion - Percutaneous Coronary Intervention (CTO-PCI) Experience in a Single, Multi-operator Australian Centre: Need for dedicated CTO-PCI programs. | Authors: | Malaiapan Y.;BoganaShanmugam V.;Psaltis P.J.;Wong D.T.;Seneviratne S. ;Cameron J. ;Meredith I.T. | Institution: | (BoganaShanmugam, Psaltis, Wong, Seneviratne, Cameron, Meredith, Malaiapan) Monash Cardiovascular Research Centre, MonashHeart and Department of Medicine, Monash Health and Monash University, Melbourne, Vic, Australia (Psaltis) School of Medicine, University of Adelaide and Vascular Research Centre, Heart Health Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia | Issue Date: | 3-Nov-2016 | Copyright year: | 2016 | Publisher: | Elsevier Ltd | Place of publication: | United Kingdom | Publication information: | Heart Lung and Circulation. 25 (7) (pp 676-682), 2016. Date of Publication: 01 Jul 2016. | Journal: | Heart Lung and Circulation | Abstract: | Background Chronic total occlusions (CTOs) represent a unique set of lesions for percutaneous coronary intervention (PCI) because of the complexity of techniques required to treat them. Methods We retrospectively reviewed the CTO-PCI experience between January 2010 and December 2012, in a multi-operator single centre, which is one of the largest volume PCI centres in Australia. Results Eighty-two patients (62.6+/-11.3 years, 85% males) who had CTO-PCIs were included. The most common site of CTO was the right coronary artery (44%), followed by the left circumflex (30%) and left anterior descending (26%) arteries. Using the Japanese CTO scoring system, 34% of lesions were classified as easy, 37% intermediate, 23% difficult and 6% very difficult. All PCIs were performed by antegrade approach. Selected procedural characteristics included: re-attempt procedure 10%; multiple access sites 21%; more than one guidewire 77%; additional support modality 60%; drug-eluting stents 97%; stent number 1.6+/-0.8; total stent length 40.1+/-24.5 mm; fluoroscopy time 33+/-17 min; contrast volume 257.2+/-110.8 mL. Overall CTO success rate was 60%. In-hospital adverse outcomes included 1.2% mortality, 9.8% peri-procedural myocardial infarction, 4.9% emergency bypass surgery, 3% cardiac tamponade and 4.9% contrast induced nephropathy. Conclusion We report modest success rates in a single Australian centre experience in a relatively conservative cohort of CTO-PCI prior to the initiation of a dedicated CTO revascularisation program.Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ) | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1016/j.hlc.2015.12.101 | PubMed URL: | 26906284 [http://www.ncbi.nlm.nih.gov/pubmed/?term=26906284] | ISSN: | 1443-9506 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/40471 | Type: | Article | Subjects: | heart tamponade/co [Complication] hematoma/co [Complication] adult hospital mortality human left anterior descending coronary artery major clinical study male fluoroscopy postoperative hemorrhage/co [Complication] priority journal retrospective study right coronary artery stent thrombosis/co [Complication] surgical approach vascular guide wire *percutaneous coronary intervention heart infarction/co [Complication] cerebrovascular accident/co [Complication] cohort analysis contrast induced nephropathy/si [Side Effect] controlled study coronary artery circumflex branch *coronary artery occlusion/th [Therapy] coronary artery perforation/co [Complication] drug eluting stent female contrast medium/ae [Adverse Drug Reaction] drug eluting stent/am [Adverse Device Effect] Antegrade approach *chronic total occlusion/th [Therapy] article Australia hematoma / complication adult Article Australia cerebrovascular accident / complication cohort analysis contrast induced nephropathy / side effect controlled study coronary artery circumflex branch *coronary artery occlusion / *therapy coronary artery perforation / complication drug eluting stent female fluoroscopy heart infarction / complication heart tamponade / complication hospital mortality human left anterior descending coronary artery major clinical study male *percutaneous coronary intervention postoperative hemorrhage / complication priority journal retrospective study right coronary artery stent thrombosis / complication surgical approach vascular guide wire |
Type of Clinical Study or Trial: | Observational study (cohort, case-control, cross sectional or survey) |
Appears in Collections: | Articles |
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