Alexandre Quadros1,2, Karlyse C Belli1, João E T de Paula3, Carlos A H de Magalhães Campos4, Antonio C B da Silva5, Ricardo Santiago6, Marcelo H Ribeiro7, Pedro P de Oliveira1, Pablo Lamelas8, Aníbal P Abelin9, Cristiano G Bezerra10, Evandro M Filho11, Felipe C Fuchs12, Félix D de Los Santos13,14, Pedro B de Andrade15, Franklin L H Quesada16, Mario Araya17, Luis A Perez18, Leandro A Côrtes19, Cleverson N Zukowski20, Marco Alcantara21, Antônio J Muniz22, Gustavo C Martinelli23, Marcelo J de Carvalho Cantarelli24, Fábio S Brito25, Sandra Baradel2, Breno de Alencar Araripe Falcão26, José A Mangione27, César R Medeiros2,28,29, Ramiro C Degrazia30,31,32, José A N Lecaro33,34, Silvio Gioppato2,35,36, Luiz F Ybarra37, Daniel Weilenmann38, Carlos A M Gottschall1, Viviana Lemke2, Lucio Padilla8. 1. Instituto de Cardiologia do Rio Grande do Sul, Porto Alegre, Brazil. 2. Sociedade Brasileira de Hemodinâmica e Cardiologia Intervencionista, Brazil. 3. Instituto Cardiovascular de Linhares UNICOR, Linhares, Brazil. 4. INCOR, São Paulo, Brazil. 5. Hospital São José do Avaí, Itaperuna, Brazil. 6. Hospital Pavia Santurce, San Juan, Puerto Rico. 7. SOS Cardio, Florianópolis, Brazil. 8. Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina. 9. ICOR, Santa Maria, Brazil. 10. Hospital Cardio-Pulmonar, Salvador, Brazil. 11. Santa Casa de Misericórdia de Maceio, Maceió, Brazil. 12. Hospital Mãe de Deus, Porto Alegre, Brazil. 13. Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico. 14. Hospital San Ángel, Mexico City, Mexico. 15. Santa Casa de Marília, Marília, Brazil. 16. Clinica Comfamiliar, Pereira, Colombia. 17. Hospital San Juan de Dios, Santiago, Chile. 18. Hospital Clinico Regional Dr Guillermo Grant Benavente, Concepción, Chile. 19. Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil. 20. Rede D'Or - Copa D'Or, Rio de Janeiro, Brazil. 21. Centro Médico 20 de Noviembre, Mexico City, Mexico. 22. Santa Casa de Misericórdia Juiz de Fora, Juiz de Fora, Brazil. 23. Hospital Santa Izabel Santa Casa Misericórdia de Salvador, Salvador, Brazil. 24. Hospital Leforte, São Paulo, Brazil. 25. Hospital São Camilo, São Paulo, Brazil. 26. Hospital de Messejana, Fortaleza, Brazil. 27. Beneficência Portuguesa de São Paulo, São Paulo, Brazil. 28. Hospital Badim, Rio de Janeiro, Brazil. 29. Hospital Unimed Rio, Rio de Janeiro, Brazil. 30. Hospital Unimed RS, Caxias do Sul, Brazil. 31. Hospital Nossa Senhora de Pompeia, Caxias do Sul, Brazil. 32. Hospital Circulo Operario Caxiense, Caxias do Sul, Brazil. 33. Hospital de Especialidades Eugenio Espejo, Quito, Ecuador. 34. Hospital de Los Valles, Quito, Ecuador. 35. Hospital de Clínicas da UNICAMP, Campinas, Brazil. 36. Hospital Vera Cruz, Campinas, Brazil. 37. London Health Sciences Centre, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada. 38. Kantosspital St Gallen, St. Gallen, Switzerland.
Abstract
OBJECTIVES: To report clinical, angiographic characteristics, outcomes, and predictors of unsuccessful procedures in patients who underwent chronic total occlusion (CTO) percutaneous coronary interventions (PCI) in Latin America. BACKGROUND: CTO PCI has been increasingly performed worldwide, but there is a lack of information in this region. METHODS: An international multicenter registry was developed to collect data on CTO PCI performed in centers in Latin America. Patient, angiographic, procedural and outcome data were evaluated. Predictors of unsuccessful procedures were assessed by multivariable analysis. RESULTS: We have included data related to 1,040 CTO PCIs performed in seven countries in Latin America (Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, and Puerto Rico). The mean age was 64 ± 10 years, and CTO PCI was performed mainly for angina control (81%) or treatment of a large ischemic area (30%). Overall technical success rate was 82.5%, and it was achieved with antegrade wire escalation in 81%, antegrade dissection/re-entry in 8% and with retrograde techniques in 11% of the successful procedures. Multivariable analysis identified moderate/severe calcification, a blunt proximal cap and a previous attempt as independent predictors of unsuccessful procedures. In-hospital major adverse cardiovascular events (MACE) occurred in 3.1% of the cases, death in 1% and cardiac tamponade in 0.9% CONCLUSIONS: CTO PCI in Latin America has been performed mainly for ischemia relief. Procedures were associated with a success rate above 80% and low incidence of MACE. Predictors of unsuccessful procedures were similar to those previously reported in the literature.
OBJECTIVES: To report clinical, angiographic characteristics, outcomes, and predictors of unsuccessful procedures in patients who underwent chronic total occlusion (CTO) percutaneous coronary interventions (PCI) in Latin America. BACKGROUND: CTO PCI has been increasingly performed worldwide, but there is a lack of information in this region. METHODS: An international multicenter registry was developed to collect data on CTO PCI performed in centers in Latin America. Patient, angiographic, procedural and outcome data were evaluated. Predictors of unsuccessful procedures were assessed by multivariable analysis. RESULTS: We have included data related to 1,040 CTO PCIs performed in seven countries in Latin America (Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, and Puerto Rico). The mean age was 64 ± 10 years, and CTO PCI was performed mainly for angina control (81%) or treatment of a large ischemic area (30%). Overall technical success rate was 82.5%, and it was achieved with antegrade wire escalation in 81%, antegrade dissection/re-entry in 8% and with retrograde techniques in 11% of the successful procedures. Multivariable analysis identified moderate/severe calcification, a blunt proximal cap and a previous attempt as independent predictors of unsuccessful procedures. In-hospital major adverse cardiovascular events (MACE) occurred in 3.1% of the cases, death in 1% and cardiac tamponade in 0.9% CONCLUSIONS: CTO PCI in Latin America has been performed mainly for ischemia relief. Procedures were associated with a success rate above 80% and low incidence of MACE. Predictors of unsuccessful procedures were similar to those previously reported in the literature.
Authors: Dagmar F Hernandez-Suarez; Lorenzo Azzalini; Francesco Moroni; João Eduardo Tinoco de Paula; Pablo Lamelas; Carlos M Campos; Marcelo Harada Ribeiro; Evandro Martins Filho; Felix Damas de Los Santos; Lucio Padilla; Marco Alcantara-Melendez; Marcelo A Abud; Israel A Almodóvar-Rivera; Marcia Moura Schmidt; Mauro Echavarria; Antonio Carlos Botelho; Valentin Del Rio; Alexandre Quadros; Ricardo Santiago Journal: Catheter Cardiovasc Interv Date: 2021-12-20 Impact factor: 2.692
Authors: Marcelo Harada Ribeiro; Carlos M Campos; Lucio Padilla; Antonio Carlos B da Silva; João Eduardo T de Paula; Marco Alcantara; Ricardo Santiago; Franklin Hanna; Franciele R da Silva; Karlyse C Belli; Lorenzo Azzalini; Pedro P de Oliveira; Gustavo N Araujo; Vincenzo Sucato; Kambis Mashayekhi; Alfredo R Galassi; Alexandre Abizaid; Alexandre Quadros Journal: J Am Heart Assoc Date: 2022-06-03 Impact factor: 6.106