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Effect of Previous Failure on Subsequent Procedural Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention (from a Contemporary Multicenter Registry).


ABSTRACT: We sought to examine the impact of previous failure on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We examined the clinical and angiographic characteristics and procedural outcomes of 1,213 consecutive patients who underwent 1,232 CTO PCIs from 2012 to 2015 at 12 US centers. Mean age was 65 ± 10 years, and 84.8% of patients were men. A previously failed attempt had been performed in 215 patients (17.5%). As compared with patients without previous CTO PCI failure, patients with previous failure had higher Multicenter CTO Registry in Japan CTO score (2.40 ± 1.13 vs 3.28 ± 1.29, p <0.0001) and were more likely to have in-stent restenosis (10.5% vs 28.4%, p <0.0001) and to undergo recanalization attempts using the retrograde approach (41% vs 50%, p = 0.011). Technical (90% vs 88%, p = 0.390) and procedural (89% vs 86%, p = 0.184) success were similar in the 2 study groups; however, median procedure time (125 vs 142 minutes, p = 0.026) and fluoroscopy time (45 vs 55 minutes, p = 0.015) were longer in the previous failure group. In conclusion, a previously failed CTO PCI attempt is associated with higher angiographic complexity, longer procedural duration, and fluoroscopy time, but not with the success and complication rates of subsequent CTO PCI attempts.

SUBMITTER: Karacsonyi J 

PROVIDER: S-EPMC4811706 | biostudies-literature | 2016 Apr

REPOSITORIES: biostudies-literature

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Effect of Previous Failure on Subsequent Procedural Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention (from a Contemporary Multicenter Registry).

Karacsonyi Judit J   Karatasakis Aris A   Karmpaliotis Dimitri D   Alaswad Khaldoon K   Yeh Robert W RW   Jaffer Farouc A FA   Wyman Michael R MR   Lombardi William L WL   Grantham J Aaron JA   Kandzari David E DE   Lembo Nicholas N   Moses Jeffrey W JW   Kirtane Ajay J AJ   Parikh Manish A MA   Green Philip P   Finn Matthew M   Garcia Santiago S   Doing Anthony A   Patel Mitul M   Bahadorani John J   Martinez Parachini Jose Roberto JR   Resendes Erica E   Rangan Bavana V BV   Ungi Imre I   Thompson Craig A CA   Banerjee Subhash S   Brilakis Emmanouil S ES  

The American journal of cardiology 20160128 8


We sought to examine the impact of previous failure on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We examined the clinical and angiographic characteristics and procedural outcomes of 1,213 consecutive patients who underwent 1,232 CTO PCIs from 2012 to 2015 at 12 US centers. Mean age was 65 ± 10 years, and 84.8% of patients were men. A previously failed attempt had been performed in 215 patients (17.5%). As compared with patients without previous CTO P  ...[more]

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