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. 2023;30(1):44-50.
doi: 10.5603/CJ.a2021.0012. Epub 2021 Feb 26.

In-hospital outcome of re-attempted percutaneous coronary interventions for chronic total occlusion

Jan-Erik Guelker  1   2 , Christian Blockhaus  3   4 , Alexander Bufe  3   4 , Knut Kroeger  5 , Julian Kürvers  4 , Dimitrios Ilousis  4 , Kambis Mashayekhi  6
Affiliations

In-hospital outcome of re-attempted percutaneous coronary interventions for chronic total occlusion

Jan-Erik Guelker et al. Cardiol J. 2023.

Abstract

Background: With the advent of novel recanalization techniques and emerging devices, percutaneous coronary intervention (PCI) has become a promising leading treatment option for patients with chronic total occlusions (CTO). The present study aims to evaluate the acute outcomes of PCI in previously failed re-attempted vs. first-attempted CTO-lesions.

Methods: Between 2012 and 2019, 619 patients were included and treated with PCI of at least one CTO. 253 patients were re-attempted lesions, while 366 were initially attempted lesions.

Results: Re-attempted lesions were more complex, including higher Japanese-CTO (J-CTO) score and the need for a retrograde approach. The procedure time and fluoroscopy time were longer in this group. Nevertheless, overall success rates were comparable between both groups of patients. In-hospital events were rare and without significant differences.

Conclusions: Re-attempted CTO lesions are more complex than first-attempt lesions and are associated with longer procedural times. However, they can be safely intervened by experienced operators with a similar success rate.

Keywords: chronic total occlusion; coronary artery disease; percutaneous coronary intervention; re-attempt.

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Conflict of interest statement

Conflict of interest: Jan-Erik Guelker received consulting/speaker honoraria from Bayer and Boeringer-Ingelheim; Christian Blockhaus: none; Alexander Bufe: none; Knut Kroeger: none; Julian Kürvers: none; Dimitrios Ilousis: none; Kambis Mashayekhi received consulting/speaker honoraria from Abbott Vascular, Asahi Intecc, Biotronik, Boston Scientific, Daiichi Sankyo, Nitiloop, Vascular Solution, Terumo.

Figures

Figure 1
Figure 1
Various parameters of initial attempted and re-attempted chronic total occlusion percutaneous coronary intervention reflecting the complexity of the lesions.
Figure 2
Figure 2
Comparison of initial attempted and re-attempted chronic total occlusion percutaneous coronary intervention regarding examination and fluoroscopy time.
See this image and copyright information in PMC

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