Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2019 Jul;31(7):E220-E225.

Left Main Chronic Total Occlusion Percutaneous Coronary Intervention: A Case Series

Iosif Xenogiannis, Dimitri Karmpaliotis, Khaldoon Alaswad, Mir B Basir, Robert W Yeh, Hector Tamez, Mitul Patel, Ehtisham Mahmud, James W Choi, M Nicholas Burke, Anthony H Doing, Phil Dattilo, Jaikirshan J Khatri, Abdul M Sheikh, Bilal A Malik, Mary E Greene, Nidal Abi Rafeh, Assaad Maalouf, Fadi Abou Jaoudeh, Jeffrey W Moses, Nicholas J Lembo, Manish Parikh, Ajay J Kirtane, Ziad A Ali, Fotis Gkargkoulas, Juan Russo, Emad Hakemi, Peter Tajti, Allison B Hall, Evangelia Vemmou, Ilias Nikolakopoulos, Bavana V Rangan, Shuaib Abdullah, Subhash Banerjee, Emmanouil S Brilakis  1
Affiliations
  • PMID: 31257217
Free article
Multicenter Study

Left Main Chronic Total Occlusion Percutaneous Coronary Intervention: A Case Series

Iosif Xenogiannis et al. J Invasive Cardiol. 2019 Jul.
Free article

Abstract

Background: Left main coronary artery (LMCA) chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study.

Methods: We reviewed 4436 CTO-PCIs performed in 4340 patients between 2012 and 2018 at 25 sites. LMCA-CTO-PCI was performed in 20 cases (0.45%). We examined the clinical and angiographic characteristics and procedural outcomes of these cases.

Results: Mean patient age was 68 ± 11 years and 65% were men. Most patients (85%) had undergone prior coronary artery bypass graft surgery and had a protected left main. Mean J-CTO score was 2.7 ± 1.3, mean PROGRESS-CTO score was 1.3 ± 1.1, and mean PROGRESS-CTO Complications score was 3.8 ± 1.9. Antegrade-wire escalation was the most common successful crossing strategy (50%), followed by retrograde crossing (30%) and antegrade dissection/re-entry (10%). Technical and procedural success rates were both 85%. One patient with failed LMCA-CTO-PCI had periprocedural myocardial infarction. Median procedure time was 178 minutes (interquartile range [IQR], 123-250 minutes), median contrast volume was 190 mL (IQR, 133-339 mL), and patient air kerma radiation dose was 2.6 Gray (IQR, 1.3-3.9 Gray).

Conclusions: LMCA-CTO-PCI is infrequent, is performed mostly in patients with prior coronary artery bypass graft surgery, and is associated with good procedural outcomes.

Keywords: chronic total occlusion; left main coronary artery; percutaneous coronary intervention.

PubMed Disclaimer

Comment in

  • A Need For Long-Term Results of LMCA-CTO-PCI.
    Cepas-Guillen P, Vásquez S, Fernandez-Valledor A, San Antonio R, Flores-Umanzor E, Martin-Yuste V, Xenogiannis I, Karmpaliotis D, Alaswad K, Basir MB, Yeh RW, Tamez H, Patel M, Mahmud E, Choi JW, Burke MN, Doing AH, Dattilo P, Khatri JJ, Sheikh AM, Malik BA, Greene ME, Abi Rafeh N, Maalouf A, Abou Jaoudeh F, Moses JW, Lembo NJ, Parikh M, Kirtane AJ, Ali ZA, Gkargkoulas F, Russo J, Hakemi E, Tajti P, Hall AB, Vemmou E, Nikolakopoulos I, Rangan BV, Abdullah S, Banerjee S, Brilakis ES. Cepas-Guillen P, et al. J Invasive Cardiol. 2019 Nov;31(11):E342. J Invasive Cardiol. 2019. PMID: 31671069 No abstract available.

Publication types

LinkOut - more resources