Format

Send to

Choose Destination
Angiology. 2019 Dec 17:3319719895178. doi: 10.1177/0003319719895178. [Epub ahead of print]

The Impact of Peripheral Artery Disease in Chronic Total Occlusion Percutaneous Coronary Intervention (Insights From PROGRESS-CTO Registry).

Author information

1
Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, MN, USA.
2
Columbia University, New York, NY, USA.
3
Henry Ford Hospital, Detroit, MI, USA.
4
Meshalkin Novosibirsk Research Institute, Novosibirsk, Russia.
5
Baylor Heart and Vascular Hospital, Dallas, TX, USA.
6
Massachusetts General Hospital, Boston, MA, USA.
7
VA San Diego Healthcare System and University of California San Diego, La Jolla, CA, USA.
8
Cleveland Clinic, Cleveland, OH, USA.
9
Piedmont Heart Institute, Atlanta, GA, USA.
10
Medical Center of the Rockies, Loveland, CO, USA.
11
University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
12
Red Cross Hospital of Athens, Athens, Greece.
13
VA Central Arkansas Healthcare System, Little Rock, AR, USA.
14
Beth Israel Deaconess Medical Center, Boston, MA, USA.
15
Torrance Memorial Medical Center, Torrance, CA, USA.
16
Tristar Centennial Medical Center, Nashville, TN, USA.
17
Emory University Hospital Midtown, Atlanta, GA, USA.
18
Wellstar Health System, Marietta, GA, USA.
19
Maimonides Medical Center, Brooklyn, NY, USA.
20
The Heart Hospital Baylor Plano, Plano, TX, USA.
21
VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, TX, USA.

Abstract

The impact of peripheral artery disease (PAD) in patients undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. We reviewed 3999 CTO PCIs performed in 3914 patients between 2012 and 2018 at 25 centers, 14% of whom had a history of PAD. We compared the clinical and angiographic characteristics and procedural outcomes of patients with versus without history of PAD. Patients with PAD were older (67 ± 9 vs 64 ± 10 years, P < .001) and had a higher prevalence of cardiovascular risk factors. They also had more complex lesions as illustrated by higher Japanese CTO score (2.7 ± 1.2 vs 2.4 ± 1.3, P < .001). In patients with PAD, the final crossing technique was less often antegrade wire escalation (40% vs 51%, P < .001) and more often the retrograde approach (23 vs 20%, P < .001) and antegrade dissection/reentry (20% vs 16%, P < .001). Technical success was similar between the 2 study groups (84% vs 87%, P = .127), but procedural success was lower for patients with PAD (81% vs 85%, P = .015). The incidence of in-hospital major adverse cardiac events was higher among patients with PAD (3% vs 2%, P = .046). In conclusion, patients with PAD undergoing CTO PCI have more comorbidities, more complex lesions, and lower procedural success.

KEYWORDS:

chronic total occlusion; percutaneous coronary intervention; peripheral artery disease

PMID:
31845593
DOI:
10.1177/0003319719895178

Supplemental Content

Full text links

Icon for Atypon
Loading ...
Support Center