Yoriyasu Suzuki1, Etsuo Tsuchikane2, Osamu Katoh3, Toshiya Muramatsu4, Makoto Muto5, Koichi Kishi6, Yuji Hamazaki7, Yuji Oikawa8, Tomohiro Kawasaki9, Atsunori Okamura10. 1. Division of Cardiovascular Medicine, Nagoya Heart Center, Aichi, Japan. 2. Department of Cardiology, Toyohashi Heart Center, Aichi, Japan. Electronic address: Tsuchikane@heart-center.or.jp. 3. Japanese CTO-PCI Expert Foundation, Okayama, Japan. 4. Department of Cardiology, Tokyo General Hospital, Tokyo, Japan. 5. Division of Cardiology, Saitama Prefecture Cardiovascular and Respiratory Center, Saitama, Japan. 6. Department of Cardiology, Tokushima Red Cross Hospital, Tokushima, Japan. 7. Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan. 8. Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan. 9. Department of Cardiology, Shin-Koga Hospital, Fukuoka, Japan. 10. Division of Cardiology, Sakurabashi-Watanabe Hospital, Osaka, Japan.
Abstract
OBJECTIVES: This report describes the registry and presents an initial analysis of outcomes for the different PCI approaches taken by the specialists. BACKGROUND: Strategies for percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) are complex. The Japanese Board of CTO Interventional Specialists has developed a prospective, nonrandomized registry of patients undergoing CTO-PCIs performed by 41 highly experienced Japanese specialists. METHODS: Over the study period of January 2014 to December 2015, the registry included 2,846 consecutive CTO-PCI cases undertaken in Japan. The authors compared clinical outcomes between the different PCI approaches, following the intention-to-treat principle. RESULTS: The overall technical success rate of the procedures was 89.9%. The specialists frequently chose a retrograde approach as the primary CTO-PCI strategy (in 27.8% of cases). The technical success rate of the primary antegrade approach was significantly better than that of the primary retrograde approach (91.0% vs. 87.3%; p < 0.0001). The technical success rate decreased to 78.0% with the rescue retrograde approach. Parallel guidewire crossing and intravascular ultrasound-guided wire crossing were performed after guidewire escalation during antegrade CTO-PCI with a high technical success rate (75.0% to 88.9%). Severe lesion calcification was a strong predictor of failed CTO-PCI. CONCLUSIONS: CTO-PCI performed by highly experienced specialists achieved a high technical success rate.
OBJECTIVES: This report describes the registry and presents an initial analysis of outcomes for the different PCI approaches taken by the specialists. BACKGROUND: Strategies for percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) are complex. The Japanese Board of CTO Interventional Specialists has developed a prospective, nonrandomized registry of patients undergoing CTO-PCIs performed by 41 highly experienced Japanese specialists. METHODS: Over the study period of January 2014 to December 2015, the registry included 2,846 consecutive CTO-PCI cases undertaken in Japan. The authors compared clinical outcomes between the different PCI approaches, following the intention-to-treat principle. RESULTS: The overall technical success rate of the procedures was 89.9%. The specialists frequently chose a retrograde approach as the primary CTO-PCI strategy (in 27.8% of cases). The technical success rate of the primary antegrade approach was significantly better than that of the primary retrograde approach (91.0% vs. 87.3%; p < 0.0001). The technical success rate decreased to 78.0% with the rescue retrograde approach. Parallel guidewire crossing and intravascular ultrasound-guided wire crossing were performed after guidewire escalation during antegrade CTO-PCI with a high technical success rate (75.0% to 88.9%). Severe lesion calcification was a strong predictor of failed CTO-PCI. CONCLUSIONS: CTO-PCI performed by highly experienced specialists achieved a high technical success rate.
Authors: Çağın Mustafa Üreyen; Kahraman Coşansu; Mustafa Gökhan Vural; Sait Emir Şahin; Mehmet Akif Çakar; Harun Kılıç; Mustafa Tarık Ağaç; Hüseyin Gündüz; Ramazan Akdemir; Ersan Tatlı Journal: Med Princ Pract Date: 2019-09-20 Impact factor: 1.927
Authors: Leszek Bryniarski; Maksymilian P Opolski; Jarosław Wójcik; Maciej Lesiak; Tomasz Pawłowski; Jakub Drozd; Wojciech Wojakowski; Sławomir Surowiec; Maciej Dąbrowski; Adam Witkowski; Dariusz Dudek; Marek Grygier; Stanisław Bartuś Journal: Postepy Kardiol Interwencyjnej Date: 2021-03-27 Impact factor: 1.426