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Peter Tajti M. Nicholas Burke Dimitri Karmpaliotis Khaldoon Alaswad Farouc A. Jaffer Robert W. Yeh Mitul Patel Ehtisham Mahmud James W. Choi Anthony H. Doing Phil Datilo Catalin Toma A.J. Conrad Smith Barry Uretsky Elizabeth Holper Santiago Garcia Oleg Krestyaninov Dimitrii Khelimskii Emmanouil S. Brilakis 《The Canadian journal of cardiology》2018,34(10):1264-1274
Background
Ostial chronic total occlusions (CTOs) can be challenging to recanalize.Methods
We sought to examine the prevalence, angiographic presentation, and procedural outcomes of ostial (side-branch ostial and aorto-ostial) CTOs among 1000 CTO percutaneous coronary interventions (PCIs) performed in 971 patients between 2015 and 2017 at 14 centres in the US, Europe, and Russia.Results
Ostial CTOs represented 16.9% of all CTO PCIs: 9.6% were aorto-ostial, and 7.3% were side-branch ostial occlusions. Compared with nonostial CTOs, ostial CTOs were longer (44 ± 33 vs 29 ± 19 mm, P < 0.001) and more likely to have proximal-cap ambiguity (55% vs 33%, P < 0.001), moderate/severe calcification (67% vs 45%, P < 0.001), a diffusely diseased distal vessel (41% vs 26%, P < 0.001), interventional collaterals (64% vs 53%, P = 0.012), and previous coronary artery bypass graft surgery (CABG) (51% vs 27%, P < 0.001). The retrograde approach was used more often in ostial CTOs (54% vs 29%, P < 0.001) and was more often the final successful crossing strategy (30% vs 18%, P = 0.003). Technical (81% vs 84%, P = 0.280), and procedural (77% vs 83%, P = 0.112) success rates and the incidence of in-hospital major complication were similar (4.8% vs 2.2%, P = 0.108), yet in-hospital mortality (3.0% vs 0.5%, P = 0.010) and stroke (1.2% vs 0.0%, P = 0.030) were higher in the ostial CTO PCI group. In multivariable analysis, ostial CTO location was not independently associated with higher risk for in-hospital major complications (adjusted odds ratio 1.27, 95% confidence intervals 0.37 to 4.51, P = 0.694).Conclusions
Ostial CTOs can be recanalized with similar rates of success as nonostial CTOs but are more complex, more likely to require retrograde crossing and may be associated with numerically higher risk for major in-hospital complications. 相似文献2.
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Toru Naganuma Kenichi Tsujita Satoru Mitomo Hisaaki Ishiguro Sandeep Basavarajaiah Katsumasa Sato Tsuyoshi Kobayashi Junei Obata Suguru Nagamatsu Kenshi Yamanaga Naohiro Komura Kenji Sakamoto Eiichiro Yamamoto Yasuhiro Izumiya Sunao Kojima Koichi Kaikita Hisao Ogawa Sunao Nakamura 《The American journal of cardiology》2018,121(12):1519-1523
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Vincent Johan Nijenhuis Jurrien Maria ten Berg Christian Hengstenberg Thierry Lefèvre Stephan Windecker David Hildick-Smith Christian Kupatt Eric Van Belle Christophe Tron Hans Ulrich Hink Antonio Colombo Bimmer Claessen Samantha Sartori Jaya Chandrasekhar Roxana Mehran Prodromos Anthopoulos Efthymios N. Deliargyris George Dangas 《The American journal of cardiology》2019,123(9):1494-1500
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Lorenzo Azzalini Luciano Candilio Soledad Ojeda Joseph Dens Alessio La Manna Susanna Benincasa Barbara Bellini Francisco Hidalgo Jorge Chavarría Joren Maeremans Giacomo Gravina Eligio Miccichè Guido DAgosta Giuseppe Venuti Corrado Tamburino Manuel Pan Mauro Carlino Antonio Colombo 《The American journal of cardiology》2018,121(10):1138-1148
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Kazuya Shinouchi Yasunori Ueda Taishi Kato Hiroki Nishida Tatsuhisa Ozaki Shumpei Kosugi Yoshinori Iida Chieko Toriyama Takuya Ohashi Masayuki Nakamura Takashi Fukushima Kohei Horiuchi Tsuyoshi Mishima Haruhiko Abe Masaki Awata Motoo Date Masaaki Uematsu Yukihiro Koretsune 《The American journal of cardiology》2019,123(12):1915-1920
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Zhi-Quan Wang Hua Qiang Xiu Luo Wei Li Kai Guo Yi-Gang Li 《The American journal of cardiology》2018,121(10):1149-1154