Long-term outcome of revascularization with percutaneous coronary intervention in a series of patients with chronic total occlusion




Background


Chronic total occlusion (CTO) is one of the last frontiers in percutaneous coronary interventions (PCI). Clinical and procedural outcomes and success rates substantially differ between clinical studies. Our study sought to evaluate PCI-related success rate and clinical and procedural outcomes on follow-up. Ischemia-driven target lesion (TLR) and vessel (TVR) revascularization, binary restenosis, thrombosis and MACE (TLR or TVR or CABG or all-cause MI or cardiovascular death) rates were evaluated among PCI-success and PCI-failure groups.




Methods and results


All patients undergoing an attempt of coronary CTO revascularization were selected for the registry. We included a total of 219 true CTOs (210 patients) performed between 2002 and 2010. CTO was defined as a coronary obstruction with TIMI flow grade 0 with an estimated duration of more than 3 months. Analyses were performed using the software packages SPSS 15.0. The median length of the follow-up was 19.2 months (IQR 7.8–38.0 months), and the follow-up rate was 96.8%. No routine angiographic follow-up assessment was done. Basal characteristics were similar in both groups. There were no major PCI-related complications, and in-hospital mortality was 0.45%. Global cardiac survival rate was 97.6% in the PCI-success group and 90.5% in the PCI-failure group. In the PCI-success group, ischemia-driven TLR, TVR and binary restenosis rates were 6.4%, 7.6% and 9.6%, respectively. Stent thrombosis rate according to ARC criteria was 0.6%.

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Nov 16, 2017 | Posted by in CARDIOLOGY | Comments Off on Long-term outcome of revascularization with percutaneous coronary intervention in a series of patients with chronic total occlusion

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