Joren Maeremans1,2, Peter Kayaert3,4, Yoann Bataille5, Johan Bennett6, Claudiu Ungureanu7, Steven Haine8, Tom Vandendriessche8, Jeroen Sonck3, Benjamin Scott9, Patrick Coussement10, Daniël Dendooven10, Bruno Pereira11, Peter Frambach11, Luc Janssens12, Philippe Debruyne12, Carlos Van Mieghem13, Emanuele Barbato13, Kristoff Cornelis14, Francis Stammen15, Frederic De Vroey16, Steven Vercauteren17, Benny Drieghe4, Adel Aminian18, Jan Debrauwere19, Stéphane Carlier20, Mark Coosemans21, Bert Van Reet21, Peter Vandergoten22, Jo Andre Dens1,2. 1. Faculty of Medicine and Life Sciences, Universiteit Hasselt , Hasselt , Belgium. 2. Department of Cardiology, Ziekenhuis Oost-Limburg , Genk , Belgium. 3. Department of Cardiology, Universitair Ziekenhuis Brussel , Brussels , Belgium. 4. Department of Cardiology, Universitair Ziekenhuis Gent , Ghent , Belgium. 5. Department of Cardiology, CHR de la Citadelle , Liège , Belgium. 6. Department of Cardiovascular Medicine, Universitair Ziekenhuis Leuven , Leuven , Belgium. 7. Department of Cardiology, Hôpital de Jolimont , Haine-Saint-Paul , Belgium. 8. Department of Cardiology, Universitair Ziekenhuis Antwerpen , Edegem , Belgium. 9. Department of Cardiology, Hartcentrum ZNA , Antwerpen , Belgium. 10. Department of Cardiology, AZ Sint-Jan Brugge , Brugge , Belgium. 11. Department of Cardiology, INCCI Haerz Zenter , Luxembourg , Luxembourg. 12. Department of Cardiology, Imelda Ziekenhuis , Bonheiden , Belgium. 13. Department of Cardiology, Onze-Lieve-Vrouw Ziekenhuis Aalst , Aalst , Belgium. 14. Department of Cardiology, AZ Maria Middelares , Ghent , Belgium. 15. Department of Cardiology, AZ Delta , Roeselare , Belgium. 16. Department of Cardiology, Grand Hôpital de Charleroi , Charleroi , Belgium. 17. Department of Cardiology, Kliniek Sint-Jan , Brussels , Belgium. 18. Department of Cardiology, CHU Charleroi , Charleroi , Belgium. 19. Department of Cardiology, ASZ Aalst , Aalst , Belgium. 20. Department of Cardiology, CHU Ambroise Paré , Mons , Belgium. 21. Department of Cardiology, AZ Turnhout , Turnhout , Belgium. 22. Department of Cardiology, Europa Ziekenhuizen , Brussels , Belgium.
Abstract
Background: Important developments in materials, devices, and techniques have improved outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI), and resulted in a growing interest in CTO-PCI. The Belgian Working Group on Chronic Total Occlusions (BWGCTO) working group aims to assess the evolution within the CTO-PCI landscape over the next years. Methods: From May 2016 onwards, patients undergoing CTO-PCI were included in the BWGCTO registry by 15 centres in Belgium and Luxemburg. Baseline, angiographic, and procedural data were collected. Here, we report on the one-year in-hospital outcomes. Results: Over the course of one year, 411 procedures in 388 patients were included with a mean age of 64 ± 11 years. The majority were male (81%). Relatively complex CTOs were treated (Japanese CTO score =2.2 ± 1.2) with a high procedure success rate (82%). Patient- and lesion-wise success rates were 83 and 85%, respectively. Major adverse in-hospital events were acceptably low (3.4%). Antegrade wire escalation technique was applied most frequently (82%). On the other hand, antegrade dissection and re-entry and retrograde strategies were more frequently applied in higher volume centres and successful for lesions with higher complexity. Conclusion: Satisfactory procedural outcomes and a low rate of adverse events were obtained in a complex CTO population, treated by operators with variable experience levels. Antegrade wire escalation was the preferred strategy, regardless of operator volume.
Background: Important developments in materials, devices, and techniques have improved outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI), and resulted in a growing interest in CTO-PCI. The Belgian Working Group on Chronic Total Occlusions (BWGCTO) working group aims to assess the evolution within the CTO-PCI landscape over the next years. Methods: From May 2016 onwards, patients undergoing CTO-PCI were included in the BWGCTO registry by 15 centres in Belgium and Luxemburg. Baseline, angiographic, and procedural data were collected. Here, we report on the one-year in-hospital outcomes. Results: Over the course of one year, 411 procedures in 388 patients were included with a mean age of 64 ± 11 years. The majority were male (81%). Relatively complex CTOs were treated (Japanese CTO score =2.2 ± 1.2) with a high procedure success rate (82%). Patient- and lesion-wise success rates were 83 and 85%, respectively. Major adverse in-hospital events were acceptably low (3.4%). Antegrade wire escalation technique was applied most frequently (82%). On the other hand, antegrade dissection and re-entry and retrograde strategies were more frequently applied in higher volume centres and successful for lesions with higher complexity. Conclusion: Satisfactory procedural outcomes and a low rate of adverse events were obtained in a complex CTO population, treated by operators with variable experience levels. Antegrade wire escalation was the preferred strategy, regardless of operator volume.
Entities:
Keywords:
Percutaneous coronary intervention; chronic total occlusion; in-hospital outcomes