Deniz Mutlu, Dimitrios Strepkos, Pedro Ep Carvalho, Michaella Alexandrou, Ahmed Al-Ogaili, Sandeep Jalli, Khaldoon Alaswad, Farouc A Jaffer, Rhian Davies, Paul Poommipanit, Jarrod Frizzel, Basem Elbarouni, Jaikirshan J Khatri, Sevket Gorgulu, Omer Goktekin, Ramazan Ozdemir, Mahmut Uluganyan, Ahmed ElGuindy, Yasser Sadek, Yousif Ahmad, Mir B Basir, Leah Raj, Luiz Ybarra, Bilal Murad, Bavana V Rangan, Olga C Mastrodemos, Lorenzo Azzalini, Yader Sandoval, M Nicholas Burke, Emmanouil S Brilakis
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引用次数: 0
Abstract
Background: The use of the Ostial Flash balloon (Ostial Corporation) has received limited study in aorto-ostial chronic total occlusion (CTO) percutaneous coronary artery intervention (PCI).
Methods: The authors evaluated the outcomes of Ostial Flash balloon use in a large CTO-PCI registry (PROGRESS-CTO, NCT02061436).
Results: The Ostial Flash balloon was used in 54 of 907 aorto-ostial CTO PCIs in 905 patients (6.0%). The mean patient age was 65.1 ± 10.7 and 80.6% were men, with a high prevalence of diabetes mellitus, hypertension, prior PCI, and prior myocardial infarction. The mean occlusion length was 40.5 ± 25.1 mm, 52.2% had moderate to severe calcification, and the mean Japanese-CTO score was 2.8 ± 1.1. Lesions treated with the Ostial Flash balloon were more frequently located in the right aorto-ostium (79.6% vs 66.0%, P = .002). In the Ostial Flash group, the most common successful CTO crossing technique was antegrade wiring (46.3%), followed by the retrograde approach (40.7%); intravascular imaging was used in 61.1% of cases. Technical success (92.6% vs 87.9%, P = .300) and the incidence of major adverse cardiac events (MACE) (5.6% vs 3.6%, P = .450) was similar in the Ostial Flash vs non-Ostial Flash patients, respectively. In multivariable analysis, PCI of proximal right coronary artery CTOs was independently associated with use of the Ostial Flash balloon (odds ratio 2.2; 95% CI, 1.1-4.8; P = .036).
Conclusions: The Ostial Flash balloon is infrequently used in aorto-ostial CTO PCI. Although there were no differences in MACE with use of the balloon, randomized controlled trials are needed to determine its effectiveness.
背景：在主动脉-口慢性全闭塞（CTO）经皮冠状动脉介入治疗（PCI）中使用口闪光球囊（Ostial Corporation）的研究有限。方法：作者评估了在大型CTO-PCI注册表（PROGRESS-CTO, NCT02061436）中使用鼻腔闪光球囊的结果。结果：905例患者907例主动脉-主动脉CTO pci中，有54例（6.0%）使用了oral Flash球囊。患者平均年龄为65.1±10.7岁，男性占80.6%，糖尿病、高血压、既往PCI、既往心肌梗死发生率高。平均咬合长度为40.5±25.1 mm， 52.2%为中至重度钙化，平均Japanese-CTO评分为2.8±1.1。经口闪光球囊治疗的病变多位于右主动脉口（79.6% vs 66.0%, P = 0.002）。在开口闪光组中，最常见的成功的CTO交叉技术是顺行布线（46.3%），其次是逆行入路（40.7%）；61.1%的病例采用血管内显像。技术成功率（92.6% vs 87.9%, P = 0.300）和主要心脏不良事件（MACE）发生率（5.6% vs 3.6%, P = 0.450）在口闪患者和非口闪患者中分别相似。在多变量分析中，右冠状动脉近端cto的PCI与使用开口闪光球囊独立相关(优势比2.2；95% ci, 1.1-4.8；P = .036)。结论：经口闪光球囊在主动脉-经口CTO PCI中应用较少。虽然使用球囊在MACE方面没有差异，但需要随机对照试验来确定其有效性。
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