Predictors of successful primary antegrade wiring in chronic total occlusion percutaneous coronary intervention.

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Invasive Cardiology Pub Date : 2024-06-01 DOI:10.25270/jic/23.00305

Athanasios Rempakos, Michaella Alexandrou, Deniz Mutlu, James W Choi, Paul Poommipanit, Jaikirshan J Khatri, Laura Young, Philip Dattilo, Yasser Sadek, Rhian Davies, Sevket Gorgulu, Farouc A Jaffer, Raj Chandwaney, Brian Jefferson, Baseem Elbarouni, Lorenzo Azzalini, Kathleen E Kearney, Khaldoon Alaswad, Mir B Basir, Oleg Krestyaninov, Dmitrii Khelimskii, Nazif Aygul, Nidal Abi-Rafeh, Ahmed Elguindy, Omer Goktekin, Bavana V Rangan, Olga C Mastrodemos, Ahmed Al-Ogaili, Yader Sandoval, M Nicholas Burke, Emmanouil S Brilakis, Arun Kalyanasundaram

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引用次数: 0

Abstract

Background: Antegrade wiring is the most commonly used chronic total occlusion (CTO) crossing technique.

Methods: Using data from the PROGRESS CTO registry (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention; Clinicaltrials.gov identifier: NCT02061436), we examined the clinical and angiographic characteristics and procedural outcomes of CTO percutaneous coronary interventions (PCIs) performed using a primary antegrade wiring strategy.

Results: Of the 13 563 CTO PCIs performed at 46 centers between 2012 and 2023, a primary antegrade wiring strategy was used in 11 332 (83.6%). Upon multivariable logistic regression analysis, proximal cap ambiguity (odds ratio [OR]: 0.52; 95% CI, 0.46-0.59), side branch at the proximal cap (OR: 0.85; 95% CI, 0.77-0.95), blunt/no stump (OR: 0.52; 95% CI: 0.47-0.59), increasing lesion length (OR [per 10 mm increase]: 0.79; 95% CI, 0.76-0.81), moderate to severe calcification (OR: 0.73; 95% CI, 0.66-0.81), moderate to severe proximal tortuosity (OR: 0.67; 95% CI, 0.59-0.75), bifurcation at the distal cap (OR: 0.66; 95% CI, 0.59-0.73), left anterior descending artery CTO (OR [vs right coronary artery]: 1.44; 95% CI, 1.28-1.62) and left circumflex CTO (OR [vs right coronary artery]: 1.22; 95% CI, 1.07-1.40), non-in-stent restenosis lesion (OR: 0.56; 95% CI, 0.49-0.65), and good distal landing zone (OR: 1.18; 95% CI, 1.06-1.32) were independently associated with primary antegrade wiring crossing success.

Conclusions: The use of antegrade wiring as the initial strategy was high (83.6%) in our registry. We identified several parameters associated with primary antegrade wiring success.

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慢性全闭塞经皮冠状动脉介入治疗中一次前向接线成功的预测因素。

背景：前向布线是最常用的慢性全闭塞（CTO）穿越技术：前向布线是最常用的慢性全闭塞（CTO）穿越技术：利用 PROGRESS CTO 登记处（慢性全闭塞干预研究前瞻性全球登记处；Clinicaltrials.gov identifier：NCT02061436）的数据，我们研究了采用主要前行布线策略进行的CTO经皮冠状动脉介入治疗（PCI）的临床和血管造影特征以及手术结果：2012年至2023年期间，在46个中心进行的13 563例CTO PCI中，有11 332例（83.6%）采用了主要逆行布线策略。经多变量逻辑回归分析，近端帽模糊性（几率比 [OR]：0.52；95% CI：0.46-0.59）、近端帽侧支（OR：0.85；95% CI：0.77-0.95）、钝/无残端（OR：0.52；95% CI：0.47-0.59）、病变长度增加（OR [每增加 10 mm]：0.79；95% CI，0.76-0.81）、中度至重度钙化（OR：0.73；95% CI，0.66-0.81）、中度至重度近端迂曲（OR：0.67；95% CI，0.59-0.75）、远端冠状动脉分叉（OR：0.66；95% CI，0.59-0.73）、左前降支动脉 CTO（OR [vs 右冠状动脉]：1.44；95% CI，1.28-1.62）和左侧环状动脉 CTO（OR [vs 右冠状动脉]：1.22；95% CI，1.07-1.40）、非支架内再狭窄病变（OR：0.56；95% CI，0.49-0.65）和良好的远端着床区（OR：1.18；95% CI，1.06-1.32）与一次前行布线穿越成功独立相关：在我们的登记册中，使用前向布线作为初始策略的比例很高（83.6%）。我们发现了几个与初次逆行接线成功率相关的参数。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Invasive Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

2.90

自引率

6.70%

发文量

214

审稿时长

3-8 weeks

期刊介绍： The Journal of Invasive Cardiology will consider for publication suitable articles on topics pertaining to the invasive treatment of patients with cardiovascular disease.