Impact of lesion length on the outcomes of chronic total occlusion percutaneous coronary intervention: Insights from the PROGRESS‐CTO registry
Background The impact of occlusion length on the procedural techniques and outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. Methods We examined the clinical and angiographic characteristics and procedural outcomes of 10,335 CTO PCIs at 42...
Gespeichert in:
| Veröffentlicht in: | Catheterization and cardiovascular interventions 2023-03, Vol.101 (4), p.747-755 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 755 |
|---|---|
| container_issue | 4 |
| container_start_page | 747 |
| container_title | Catheterization and cardiovascular interventions |
| container_volume | 101 |
| creator | Rempakos, Athanasios Simsek, Bahadir Kostantinis, Spyridon Karacsonyi, Judit Choi, James W. Poommipanit, Paul Khatri, Jaikirshan J. Jaber, Wissam Rinfret, Stephane Nicholson, William Gorgulu, Sevket Jaffer, Farouc A. Chandwaney, Raj Koutouzis, Michael Tsiafoutis, Ioannis Alaswad, Khaldoon Krestyaninov, Oleg Khelimskii, Dmitrii Karmpaliotis, Dimitrios Uretsky, Barry F. Patel, Mitul P. Mahmud, Ehtisham Potluri, Srinivasa Rangan, Bavana V. Mastrodemos, Olga C. Allana, Salman Sandoval, Yader Burke, Nicholas M. Brilakis, Emmanouil S. |
| description | Background
The impact of occlusion length on the procedural techniques and outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study.
Methods
We examined the clinical and angiographic characteristics and procedural outcomes of 10,335 CTO PCIs at 42 US and non‐US centers between 2012 and 2022. The cohort was divided into two groups based on lesion length (≥20 mm vs. |
| doi_str_mv | 10.1002/ccd.30581 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2773719926</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2785846806</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3531-9e4655c2cf18399b14e9b2a8d3f113c3ef1151faa3483baa2a7b121f5439a67a3</originalsourceid><addsrcrecordid>eNp10U9P2zAYBnBrAg3W7bAvgCxxYYe2_pM4MbcpQKmE1Ak6abfIcd-0QUnc2Q6oNz5CPyOfBLcpHCbt9L6Hnx_ZfhD6TsmIEsLGWi9GnMQp_YROaczYMGHiz9FhpzISJ-iLc4-EECmY_IxOuEgiwrg4Rdtps1baY1PiGlxl2jDapV_hsPkVYNN5bRpwO6BX1rSVxt54VWOjdd3tT6zB6s6rFkznsDYBKbvBVevBPkHrA7nE09ZVy5V3uLSm2Sf_up9N7q8fHl5fttl8hi0sK-ft5is6LlXt4NthDtDvm-t5dju8m02m2c-7oeYxp0MJkYhjzXRJUy5lQSOQBVPpgpeUcs0hjJiWSvEo5YVSTCUFZbSMIy6VSBQfoIs-d23N3w6cz5vKaajr_h05SxKeUCmZCPT8H_poOtuG2wWVxmkkUrJTP3qlrXHOQpmvbdWEn8gpyXc15aGmfF9TsGeHxK5oYPEh33sJYNyD56qGzf-T8iy76iPfAMOQnkA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2785846806</pqid></control><display><type>article</type><title>Impact of lesion length on the outcomes of chronic total occlusion percutaneous coronary intervention: Insights from the PROGRESS‐CTO registry</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Rempakos, Athanasios ; Simsek, Bahadir ; Kostantinis, Spyridon ; Karacsonyi, Judit ; Choi, James W. ; Poommipanit, Paul ; Khatri, Jaikirshan J. ; Jaber, Wissam ; Rinfret, Stephane ; Nicholson, William ; Gorgulu, Sevket ; Jaffer, Farouc A. ; Chandwaney, Raj ; Koutouzis, Michael ; Tsiafoutis, Ioannis ; Alaswad, Khaldoon ; Krestyaninov, Oleg ; Khelimskii, Dmitrii ; Karmpaliotis, Dimitrios ; Uretsky, Barry F. ; Patel, Mitul P. ; Mahmud, Ehtisham ; Potluri, Srinivasa ; Rangan, Bavana V. ; Mastrodemos, Olga C. ; Allana, Salman ; Sandoval, Yader ; Burke, Nicholas M. ; Brilakis, Emmanouil S.</creator><creatorcontrib>Rempakos, Athanasios ; Simsek, Bahadir ; Kostantinis, Spyridon ; Karacsonyi, Judit ; Choi, James W. ; Poommipanit, Paul ; Khatri, Jaikirshan J. ; Jaber, Wissam ; Rinfret, Stephane ; Nicholson, William ; Gorgulu, Sevket ; Jaffer, Farouc A. ; Chandwaney, Raj ; Koutouzis, Michael ; Tsiafoutis, Ioannis ; Alaswad, Khaldoon ; Krestyaninov, Oleg ; Khelimskii, Dmitrii ; Karmpaliotis, Dimitrios ; Uretsky, Barry F. ; Patel, Mitul P. ; Mahmud, Ehtisham ; Potluri, Srinivasa ; Rangan, Bavana V. ; Mastrodemos, Olga C. ; Allana, Salman ; Sandoval, Yader ; Burke, Nicholas M. ; Brilakis, Emmanouil S.</creatorcontrib><description><![CDATA[Background
The impact of occlusion length on the procedural techniques and outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study.
Methods
We examined the clinical and angiographic characteristics and procedural outcomes of 10,335 CTO PCIs at 42 US and non‐US centers between 2012 and 2022. The cohort was divided into two groups based on lesion length (≥20 mm vs. <20 mm).
Results
Long lesions were present in 7208 (70%) patients. Comorbidities were more common in patients with long CTOs. Compared with short lesions, long lesions had higher J‐CTO score (2.8 ± 1.1 vs. 1.3 ± 1; p < 0.001) and retrograde wiring was more often the initial (15.5% vs. 4.0%; p < 0.001) and successful (22.8% vs. 8.2%; p < 0.001) crossing strategy. Long lesions were more likely to require longer procedure (123 vs. 91 min; p < 0.001) and fluoroscopy (47.1 vs. 32.2 min; p < 0.001) time, larger contrast volume (218 vs. 200 mL; p < 0.001) and higher air kerma radiation dose (2.4 vs. 1.7 Gy; p < 0.001). After adjusting for potential confounders, long lesions were associated with lower technical success (odds ratio [OR]: 0.91 per 10 mm increase; 95% confidence interval [CI]: 0.88, 0.94) and higher major adverse cardiovascular events (MACE) (OR: 1.08 per 10 mm increase; 95% CI: 1.02, 1.15).
Conclusions
CTO PCI of long occlusions is independently associated with lower rates of technical success and higher rates of in‐hospital MACE.]]></description><identifier>ISSN: 1522-1946</identifier><identifier>EISSN: 1522-726X</identifier><identifier>DOI: 10.1002/ccd.30581</identifier><identifier>PMID: 36740236</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Angioplasty ; Chronic Disease ; chronic total occlusion ; Comorbidity ; Coronary Angiography - methods ; Coronary Occlusion - etiology ; Fluoroscopy ; Humans ; lesion length ; Lesions ; Occlusion ; occlusion length ; Patients ; percutaneous coronary intervention ; Percutaneous Coronary Intervention - adverse effects ; Registries ; Risk Factors ; Treatment Outcome</subject><ispartof>Catheterization and cardiovascular interventions, 2023-03, Vol.101 (4), p.747-755</ispartof><rights>2023 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3531-9e4655c2cf18399b14e9b2a8d3f113c3ef1151faa3483baa2a7b121f5439a67a3</citedby><cites>FETCH-LOGICAL-c3531-9e4655c2cf18399b14e9b2a8d3f113c3ef1151faa3483baa2a7b121f5439a67a3</cites><orcidid>0000-0003-1099-681X ; 0000-0001-7835-793X ; 0000-0003-4800-2972 ; 0000-0003-4775-1402 ; 0000-0001-7980-384X ; 0000-0002-6991-7621 ; 0000-0001-5419-913X ; 0000-0002-2683-5255 ; 0000-0002-0315-3219 ; 0000-0001-6198-8006 ; 0000-0001-9416-9701 ; 0000-0003-1069-2437 ; 0000-0002-2884-7778</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fccd.30581$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fccd.30581$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36740236$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rempakos, Athanasios</creatorcontrib><creatorcontrib>Simsek, Bahadir</creatorcontrib><creatorcontrib>Kostantinis, Spyridon</creatorcontrib><creatorcontrib>Karacsonyi, Judit</creatorcontrib><creatorcontrib>Choi, James W.</creatorcontrib><creatorcontrib>Poommipanit, Paul</creatorcontrib><creatorcontrib>Khatri, Jaikirshan J.</creatorcontrib><creatorcontrib>Jaber, Wissam</creatorcontrib><creatorcontrib>Rinfret, Stephane</creatorcontrib><creatorcontrib>Nicholson, William</creatorcontrib><creatorcontrib>Gorgulu, Sevket</creatorcontrib><creatorcontrib>Jaffer, Farouc A.</creatorcontrib><creatorcontrib>Chandwaney, Raj</creatorcontrib><creatorcontrib>Koutouzis, Michael</creatorcontrib><creatorcontrib>Tsiafoutis, Ioannis</creatorcontrib><creatorcontrib>Alaswad, Khaldoon</creatorcontrib><creatorcontrib>Krestyaninov, Oleg</creatorcontrib><creatorcontrib>Khelimskii, Dmitrii</creatorcontrib><creatorcontrib>Karmpaliotis, Dimitrios</creatorcontrib><creatorcontrib>Uretsky, Barry F.</creatorcontrib><creatorcontrib>Patel, Mitul P.</creatorcontrib><creatorcontrib>Mahmud, Ehtisham</creatorcontrib><creatorcontrib>Potluri, Srinivasa</creatorcontrib><creatorcontrib>Rangan, Bavana V.</creatorcontrib><creatorcontrib>Mastrodemos, Olga C.</creatorcontrib><creatorcontrib>Allana, Salman</creatorcontrib><creatorcontrib>Sandoval, Yader</creatorcontrib><creatorcontrib>Burke, Nicholas M.</creatorcontrib><creatorcontrib>Brilakis, Emmanouil S.</creatorcontrib><title>Impact of lesion length on the outcomes of chronic total occlusion percutaneous coronary intervention: Insights from the PROGRESS‐CTO registry</title><title>Catheterization and cardiovascular interventions</title><addtitle>Catheter Cardiovasc Interv</addtitle><description><![CDATA[Background
The impact of occlusion length on the procedural techniques and outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study.
Methods
We examined the clinical and angiographic characteristics and procedural outcomes of 10,335 CTO PCIs at 42 US and non‐US centers between 2012 and 2022. The cohort was divided into two groups based on lesion length (≥20 mm vs. <20 mm).
Results
Long lesions were present in 7208 (70%) patients. Comorbidities were more common in patients with long CTOs. Compared with short lesions, long lesions had higher J‐CTO score (2.8 ± 1.1 vs. 1.3 ± 1; p < 0.001) and retrograde wiring was more often the initial (15.5% vs. 4.0%; p < 0.001) and successful (22.8% vs. 8.2%; p < 0.001) crossing strategy. Long lesions were more likely to require longer procedure (123 vs. 91 min; p < 0.001) and fluoroscopy (47.1 vs. 32.2 min; p < 0.001) time, larger contrast volume (218 vs. 200 mL; p < 0.001) and higher air kerma radiation dose (2.4 vs. 1.7 Gy; p < 0.001). After adjusting for potential confounders, long lesions were associated with lower technical success (odds ratio [OR]: 0.91 per 10 mm increase; 95% confidence interval [CI]: 0.88, 0.94) and higher major adverse cardiovascular events (MACE) (OR: 1.08 per 10 mm increase; 95% CI: 1.02, 1.15).
Conclusions
CTO PCI of long occlusions is independently associated with lower rates of technical success and higher rates of in‐hospital MACE.]]></description><subject>Angioplasty</subject><subject>Chronic Disease</subject><subject>chronic total occlusion</subject><subject>Comorbidity</subject><subject>Coronary Angiography - methods</subject><subject>Coronary Occlusion - etiology</subject><subject>Fluoroscopy</subject><subject>Humans</subject><subject>lesion length</subject><subject>Lesions</subject><subject>Occlusion</subject><subject>occlusion length</subject><subject>Patients</subject><subject>percutaneous coronary intervention</subject><subject>Percutaneous Coronary Intervention - adverse effects</subject><subject>Registries</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><issn>1522-1946</issn><issn>1522-726X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10U9P2zAYBnBrAg3W7bAvgCxxYYe2_pM4MbcpQKmE1Ak6abfIcd-0QUnc2Q6oNz5CPyOfBLcpHCbt9L6Hnx_ZfhD6TsmIEsLGWi9GnMQp_YROaczYMGHiz9FhpzISJ-iLc4-EECmY_IxOuEgiwrg4Rdtps1baY1PiGlxl2jDapV_hsPkVYNN5bRpwO6BX1rSVxt54VWOjdd3tT6zB6s6rFkznsDYBKbvBVevBPkHrA7nE09ZVy5V3uLSm2Sf_up9N7q8fHl5fttl8hi0sK-ft5is6LlXt4NthDtDvm-t5dju8m02m2c-7oeYxp0MJkYhjzXRJUy5lQSOQBVPpgpeUcs0hjJiWSvEo5YVSTCUFZbSMIy6VSBQfoIs-d23N3w6cz5vKaajr_h05SxKeUCmZCPT8H_poOtuG2wWVxmkkUrJTP3qlrXHOQpmvbdWEn8gpyXc15aGmfF9TsGeHxK5oYPEh33sJYNyD56qGzf-T8iy76iPfAMOQnkA</recordid><startdate>20230301</startdate><enddate>20230301</enddate><creator>Rempakos, Athanasios</creator><creator>Simsek, Bahadir</creator><creator>Kostantinis, Spyridon</creator><creator>Karacsonyi, Judit</creator><creator>Choi, James W.</creator><creator>Poommipanit, Paul</creator><creator>Khatri, Jaikirshan J.</creator><creator>Jaber, Wissam</creator><creator>Rinfret, Stephane</creator><creator>Nicholson, William</creator><creator>Gorgulu, Sevket</creator><creator>Jaffer, Farouc A.</creator><creator>Chandwaney, Raj</creator><creator>Koutouzis, Michael</creator><creator>Tsiafoutis, Ioannis</creator><creator>Alaswad, Khaldoon</creator><creator>Krestyaninov, Oleg</creator><creator>Khelimskii, Dmitrii</creator><creator>Karmpaliotis, Dimitrios</creator><creator>Uretsky, Barry F.</creator><creator>Patel, Mitul P.</creator><creator>Mahmud, Ehtisham</creator><creator>Potluri, Srinivasa</creator><creator>Rangan, Bavana V.</creator><creator>Mastrodemos, Olga C.</creator><creator>Allana, Salman</creator><creator>Sandoval, Yader</creator><creator>Burke, Nicholas M.</creator><creator>Brilakis, Emmanouil S.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1099-681X</orcidid><orcidid>https://orcid.org/0000-0001-7835-793X</orcidid><orcidid>https://orcid.org/0000-0003-4800-2972</orcidid><orcidid>https://orcid.org/0000-0003-4775-1402</orcidid><orcidid>https://orcid.org/0000-0001-7980-384X</orcidid><orcidid>https://orcid.org/0000-0002-6991-7621</orcidid><orcidid>https://orcid.org/0000-0001-5419-913X</orcidid><orcidid>https://orcid.org/0000-0002-2683-5255</orcidid><orcidid>https://orcid.org/0000-0002-0315-3219</orcidid><orcidid>https://orcid.org/0000-0001-6198-8006</orcidid><orcidid>https://orcid.org/0000-0001-9416-9701</orcidid><orcidid>https://orcid.org/0000-0003-1069-2437</orcidid><orcidid>https://orcid.org/0000-0002-2884-7778</orcidid></search><sort><creationdate>20230301</creationdate><title>Impact of lesion length on the outcomes of chronic total occlusion percutaneous coronary intervention: Insights from the PROGRESS‐CTO registry</title><author>Rempakos, Athanasios ; Simsek, Bahadir ; Kostantinis, Spyridon ; Karacsonyi, Judit ; Choi, James W. ; Poommipanit, Paul ; Khatri, Jaikirshan J. ; Jaber, Wissam ; Rinfret, Stephane ; Nicholson, William ; Gorgulu, Sevket ; Jaffer, Farouc A. ; Chandwaney, Raj ; Koutouzis, Michael ; Tsiafoutis, Ioannis ; Alaswad, Khaldoon ; Krestyaninov, Oleg ; Khelimskii, Dmitrii ; Karmpaliotis, Dimitrios ; Uretsky, Barry F. ; Patel, Mitul P. ; Mahmud, Ehtisham ; Potluri, Srinivasa ; Rangan, Bavana V. ; Mastrodemos, Olga C. ; Allana, Salman ; Sandoval, Yader ; Burke, Nicholas M. ; Brilakis, Emmanouil S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3531-9e4655c2cf18399b14e9b2a8d3f113c3ef1151faa3483baa2a7b121f5439a67a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Angioplasty</topic><topic>Chronic Disease</topic><topic>chronic total occlusion</topic><topic>Comorbidity</topic><topic>Coronary Angiography - methods</topic><topic>Coronary Occlusion - etiology</topic><topic>Fluoroscopy</topic><topic>Humans</topic><topic>lesion length</topic><topic>Lesions</topic><topic>Occlusion</topic><topic>occlusion length</topic><topic>Patients</topic><topic>percutaneous coronary intervention</topic><topic>Percutaneous Coronary Intervention - adverse effects</topic><topic>Registries</topic><topic>Risk Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rempakos, Athanasios</creatorcontrib><creatorcontrib>Simsek, Bahadir</creatorcontrib><creatorcontrib>Kostantinis, Spyridon</creatorcontrib><creatorcontrib>Karacsonyi, Judit</creatorcontrib><creatorcontrib>Choi, James W.</creatorcontrib><creatorcontrib>Poommipanit, Paul</creatorcontrib><creatorcontrib>Khatri, Jaikirshan J.</creatorcontrib><creatorcontrib>Jaber, Wissam</creatorcontrib><creatorcontrib>Rinfret, Stephane</creatorcontrib><creatorcontrib>Nicholson, William</creatorcontrib><creatorcontrib>Gorgulu, Sevket</creatorcontrib><creatorcontrib>Jaffer, Farouc A.</creatorcontrib><creatorcontrib>Chandwaney, Raj</creatorcontrib><creatorcontrib>Koutouzis, Michael</creatorcontrib><creatorcontrib>Tsiafoutis, Ioannis</creatorcontrib><creatorcontrib>Alaswad, Khaldoon</creatorcontrib><creatorcontrib>Krestyaninov, Oleg</creatorcontrib><creatorcontrib>Khelimskii, Dmitrii</creatorcontrib><creatorcontrib>Karmpaliotis, Dimitrios</creatorcontrib><creatorcontrib>Uretsky, Barry F.</creatorcontrib><creatorcontrib>Patel, Mitul P.</creatorcontrib><creatorcontrib>Mahmud, Ehtisham</creatorcontrib><creatorcontrib>Potluri, Srinivasa</creatorcontrib><creatorcontrib>Rangan, Bavana V.</creatorcontrib><creatorcontrib>Mastrodemos, Olga C.</creatorcontrib><creatorcontrib>Allana, Salman</creatorcontrib><creatorcontrib>Sandoval, Yader</creatorcontrib><creatorcontrib>Burke, Nicholas M.</creatorcontrib><creatorcontrib>Brilakis, Emmanouil S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Catheterization and cardiovascular interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rempakos, Athanasios</au><au>Simsek, Bahadir</au><au>Kostantinis, Spyridon</au><au>Karacsonyi, Judit</au><au>Choi, James W.</au><au>Poommipanit, Paul</au><au>Khatri, Jaikirshan J.</au><au>Jaber, Wissam</au><au>Rinfret, Stephane</au><au>Nicholson, William</au><au>Gorgulu, Sevket</au><au>Jaffer, Farouc A.</au><au>Chandwaney, Raj</au><au>Koutouzis, Michael</au><au>Tsiafoutis, Ioannis</au><au>Alaswad, Khaldoon</au><au>Krestyaninov, Oleg</au><au>Khelimskii, Dmitrii</au><au>Karmpaliotis, Dimitrios</au><au>Uretsky, Barry F.</au><au>Patel, Mitul P.</au><au>Mahmud, Ehtisham</au><au>Potluri, Srinivasa</au><au>Rangan, Bavana V.</au><au>Mastrodemos, Olga C.</au><au>Allana, Salman</au><au>Sandoval, Yader</au><au>Burke, Nicholas M.</au><au>Brilakis, Emmanouil S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of lesion length on the outcomes of chronic total occlusion percutaneous coronary intervention: Insights from the PROGRESS‐CTO registry</atitle><jtitle>Catheterization and cardiovascular interventions</jtitle><addtitle>Catheter Cardiovasc Interv</addtitle><date>2023-03-01</date><risdate>2023</risdate><volume>101</volume><issue>4</issue><spage>747</spage><epage>755</epage><pages>747-755</pages><issn>1522-1946</issn><eissn>1522-726X</eissn><abstract><![CDATA[Background
The impact of occlusion length on the procedural techniques and outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study.
Methods
We examined the clinical and angiographic characteristics and procedural outcomes of 10,335 CTO PCIs at 42 US and non‐US centers between 2012 and 2022. The cohort was divided into two groups based on lesion length (≥20 mm vs. <20 mm).
Results
Long lesions were present in 7208 (70%) patients. Comorbidities were more common in patients with long CTOs. Compared with short lesions, long lesions had higher J‐CTO score (2.8 ± 1.1 vs. 1.3 ± 1; p < 0.001) and retrograde wiring was more often the initial (15.5% vs. 4.0%; p < 0.001) and successful (22.8% vs. 8.2%; p < 0.001) crossing strategy. Long lesions were more likely to require longer procedure (123 vs. 91 min; p < 0.001) and fluoroscopy (47.1 vs. 32.2 min; p < 0.001) time, larger contrast volume (218 vs. 200 mL; p < 0.001) and higher air kerma radiation dose (2.4 vs. 1.7 Gy; p < 0.001). After adjusting for potential confounders, long lesions were associated with lower technical success (odds ratio [OR]: 0.91 per 10 mm increase; 95% confidence interval [CI]: 0.88, 0.94) and higher major adverse cardiovascular events (MACE) (OR: 1.08 per 10 mm increase; 95% CI: 1.02, 1.15).
Conclusions
CTO PCI of long occlusions is independently associated with lower rates of technical success and higher rates of in‐hospital MACE.]]></abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>36740236</pmid><doi>10.1002/ccd.30581</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-1099-681X</orcidid><orcidid>https://orcid.org/0000-0001-7835-793X</orcidid><orcidid>https://orcid.org/0000-0003-4800-2972</orcidid><orcidid>https://orcid.org/0000-0003-4775-1402</orcidid><orcidid>https://orcid.org/0000-0001-7980-384X</orcidid><orcidid>https://orcid.org/0000-0002-6991-7621</orcidid><orcidid>https://orcid.org/0000-0001-5419-913X</orcidid><orcidid>https://orcid.org/0000-0002-2683-5255</orcidid><orcidid>https://orcid.org/0000-0002-0315-3219</orcidid><orcidid>https://orcid.org/0000-0001-6198-8006</orcidid><orcidid>https://orcid.org/0000-0001-9416-9701</orcidid><orcidid>https://orcid.org/0000-0003-1069-2437</orcidid><orcidid>https://orcid.org/0000-0002-2884-7778</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1522-1946 |
| ispartof | Catheterization and cardiovascular interventions, 2023-03, Vol.101 (4), p.747-755 |
| issn | 1522-1946 1522-726X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2773719926 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Angioplasty Chronic Disease chronic total occlusion Comorbidity Coronary Angiography - methods Coronary Occlusion - etiology Fluoroscopy Humans lesion length Lesions Occlusion occlusion length Patients percutaneous coronary intervention Percutaneous Coronary Intervention - adverse effects Registries Risk Factors Treatment Outcome |
| title | Impact of lesion length on the outcomes of chronic total occlusion percutaneous coronary intervention: Insights from the PROGRESS‐CTO registry |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-19T22%3A00%3A38IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Impact%20of%20lesion%20length%20on%20the%20outcomes%20of%20chronic%20total%20occlusion%20percutaneous%20coronary%20intervention:%20Insights%20from%20the%20PROGRESS%E2%80%90CTO%20registry&rft.jtitle=Catheterization%20and%20cardiovascular%20interventions&rft.au=Rempakos,%20Athanasios&rft.date=2023-03-01&rft.volume=101&rft.issue=4&rft.spage=747&rft.epage=755&rft.pages=747-755&rft.issn=1522-1946&rft.eissn=1522-726X&rft_id=info:doi/10.1002/ccd.30581&rft_dat=%3Cproquest_cross%3E2785846806%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2785846806&rft_id=info:pmid/36740236&rfr_iscdi=true |