Simone Budassi1,2, Carlo Zivelonghi1, Joseph Dens3, Alan J Bagnall4, Paul Knaapen5, Alexandre Avran6, James C Spratt7, Simon Walsh8, Benjamin Faurie9, Pierfrancesco Agostoni1. 1. Hartcentrum, Ziekenhuis Netwerk Antwerpen (ZNA) Middelheim, Antwerp, Belgium. 2. Cardiology and Interventional Cardiology Department, Policlinico Tor Vergata, Rome, Italy. 3. Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium. 4. Freeman Hospital, The Newcastle upon Tyne hospitals NHS Trust, Newcastle, UK. 5. Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands. 6. Department of Interventional Cardiology, Arnault Tzanck Institute, Saint-Laurent-du-Var, France. 7. Department of Cardiology, St George's University Healthcare NHS Trust, London, UK. 8. Department of Cardiology, Belfast Health & Social Care Trust, Belfast, Northern Ireland, UK. 9. Cardiovascular Institute, Groupe Hospitalier Mutualiste, Grenoble, France.
Abstract
AIM: Chronic total occlusions (CTO) in patients with history of coronary artery bypass graft (CABG) show more advanced and complex atherosclerotic pathology. Aim of our study is to compare outcomes in patients undergoing CTO percutaneous coronary intervention (PCI) with previous CABG versus those without in the REgistry of Crossboss and Hybrid procedures in FrAnce the NetheRlands, BelGium and UnitEd Kingdom (RECHARGE). METHODS & RESULTS: The RECHARGE cohort (1,252 patients) was divided in two groups according to the presence of previous CABG (217) or not. We also focused, in the post-CABG group, on a comparison between CTO in previously grafted vessels versus non-grafted vessels. The CTO complexity scores were higher and the success rate (71.9% vs. 88.7%, p < .001) was lower in the CABG group, this difference was driven by higher failure rates in high-complexity-score CTO. The rate of in-hospital complications was similar. In the post-CABG group, the procedural success of CTO located in previously grafted vessels versus those in vessels not previously grafted, was comparably suboptimal (73.1% vs. 68%, p = .47). CONCLUSION: Patients undergoing CTO PCI with prior CABG have a higher prevalence of comorbidities and more complex lesion characteristics. In the post-CABG population the success rate was significantly lower, particularly in high CTO complexity scores, though complication rates were comparable. In the post-CABG population, the CTO success rate was independent of the presence of a previous graft on the CTO vessel.
AIM: Chronic total occlusions (CTO) in patients with history of coronary artery bypass graft (CABG) show more advanced and complex atherosclerotic pathology. Aim of our study is to compare outcomes in patients undergoing CTO percutaneous coronary intervention (PCI) with previous CABG versus those without in the REgistry of Crossboss and Hybrid procedures in FrAnce the NetheRlands, BelGium and UnitEd Kingdom (RECHARGE). METHODS & RESULTS: The RECHARGE cohort (1,252 patients) was divided in two groups according to the presence of previous CABG (217) or not. We also focused, in the post-CABG group, on a comparison between CTO in previously grafted vessels versus non-grafted vessels. The CTO complexity scores were higher and the success rate (71.9% vs. 88.7%, p < .001) was lower in the CABG group, this difference was driven by higher failure rates in high-complexity-score CTO. The rate of in-hospital complications was similar. In the post-CABG group, the procedural success of CTO located in previously grafted vessels versus those in vessels not previously grafted, was comparably suboptimal (73.1% vs. 68%, p = .47). CONCLUSION:Patients undergoing CTO PCI with prior CABG have a higher prevalence of comorbidities and more complex lesion characteristics. In the post-CABG population the success rate was significantly lower, particularly in high CTO complexity scores, though complication rates were comparable. In the post-CABG population, the CTO success rate was independent of the presence of a previous graft on the CTO vessel.
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: Ruben W de Winter; Mohammed S Rahman; Pepijn A van Diemen; Stefan P Schumacher; Ruurt A Jukema; Yvemarie B O Somsen; Albert C van Rossum; Niels J Verouden; Ibrahim Danad; Ronak Delewi; Alexander Nap; Paul Knaapen Journal: Curr Cardiol Rep Date: 2022-08-04 Impact factor: 3.955