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
. 2022 Mar;75(3):213-222.
doi: 10.1016/j.rec.2021.06.011. Epub 2021 Jul 21.

Plaque modification in calcified chronic total occlusions: the PLACCTON study

[Article in English, Spanish]
José R Delgado-Arana  1 , José R Rumoroso  2 , Ander Regueiro  3 , Javier Martín-Moreiras  4 , Gema Miñana  5 , Mohsen Mohandes  6 , Manuel Pan  7 , Pablo Salinas  8 , Juan Caballero-Borrego  9 , José A Fernández-Díaz  10 , Alfonso Jurado-Román  11 , Javier Lacunza  12 , Beatriz Vaquerizo  13 , Fernando Rivero  14 , José Abellán-Huerta  15 , Juan Rondán  16 , Antonio Gómez Menchero  17 , Sandra Santos-Martínez  1 , Asier Subinas  2 , Víctor Arévalos  3 , Alejandro Diego Nieto  4 , Juan Sanchis  5 , Sergio Rojas  6 , Soledad Ojeda  7 , Nieves Gonzalo  8 , Manuel López-Pérez  9 , Javier Goicolea  10 , Mario Sádaba  2 , Itziar Gómez-Salvador  1 , Manel Sabaté  3 , Jean Carlos Núñez García  4 , Ignacio J Amat-Santos  18
Affiliations

Plaque modification in calcified chronic total occlusions: the PLACCTON study

[Article in English, Spanish]
José R Delgado-Arana et al. Rev Esp Cardiol (Engl Ed). 2022 Mar.

Abstract

Introduction and objectives: Severe calcification is present in> 50% of coronary chronic total occlusions (CTOs) undergoing percutaneous intervention. We aimed to describe the contemporary use and outcomes of plaque modification devices (PMDs) in this context.

Methods: Patients were included in the prospective, consecutive Iberian CTO registry (32 centers in Spain and Portugal), from 2015 to 2020. Comparison was performed according to the use of PMDs.

Results: Among 2235 patients, wire crossing was achieved in 1900 patients and PMDs were used in 134 patients (7%), requiring more than 1 PMD in 24 patients (1%). The selected PMDs were rotational atherectomy (35.1%), lithotripsy (5.2%), laser (11.2%), cutting/scoring balloons (27.6%), OPN balloons (2.9%), or a combination of PMDs (18%). PMDs were used in older patients, with greater cardiovascular burden, and higher Syntax and J-CTO scores. This greater complexity was associated with longer procedural time but similar total stent length (52 vs 57mm; P=.105). If the wire crossed, the procedural success rate was 87.2% but increased to 96.3% when PMDs were used (P=.001). Conversely, PMDs were not associated with a higher rate of procedural complications (3.7 vs 3.2%; P=.615). Despite the worse baseline profile, at 2 years of follow-up there were no differences in the survival rate (PMDs: 94.3% vs no-PMDs: 94.3%, respectively; P=.967).

Conclusions: Following successful wire crossing in CTOs, PMDs were used in 7% of the lesions with an increased success rate. Mid-term outcomes were comparable despite their worse baseline profile, suggesting that broader use of PMDs in this setting might have potential technical and prognostic benefits.

Keywords: Aterectomía rotacional; Balón de corte; CTO; Cutting balloon; Excimer Laser Coronary Angioplasty; Lithotripsy; Litotricia; Láser excimer coronario; OCT; Rotational atherectomy.

PubMed Disclaimer