The Impact of Proximal Vessel Tortuosity on the Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Contemporary Multicenter Registry
Karacsonyi J, Karmpaliotis D, Alaswad K, Jaffer FA, Yeh RW, Patel M, Mahmud E, Doing A, Toma C, Uretsky B, Choi J, Moses JW, Kirtane A, Parikh M, Ali Z, Lombardi WL, Kandzari DE, Lembo N, Garcia S, Wyman MR, Martinez-Parachini JR, Karatasakis A, Danek BA, Alame AJ, Resendes E, Rangan BV, Ungi I, Thompson CA, Banerjee S, Brilakis ES. The impact of proximal vessel tortuosity on the outcomes of chronic total occlusion percutaneous coronary intervention: Insights from a contemporary multicenter registry. J Invasive Cardiol. Aug 2017;29(8):264-270.
The Journal of invasive cardiology
INTRODUCTION: We examined the impact of proximal vessel tortuosity on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
METHODS: The baseline clinical and angiographic characteristics and procedural outcomes of 1618 consecutive CTO-PCIs performed between 2012 and 2016 at 14 United States centers in 1589 patients were reviewed.
RESULTS: Mean patient age was 65.3 ± 10.0 years and 85% were men. Moderate/severe proximal vessel tortuosity was present in 35.7% of target lesions. Compared with non-tortuous lesions, tortuous lesions had longer length (30 mm [interquartile range, 20-50 mm] vs 28 mm [interquartile range, 16-40 mm]; P
CONCLUSION: In a contemporary multicenter registry, moderate/severe proximal vessel tortuosity was present in approximately one-third of target CTO lesions and was associated with more frequent use of the retrograde approach and lower success rates, but similar complication rates.
Medical Subject Headings
Aged; Contrast Media; Coronary Angiography; Coronary Occlusion; Coronary Vessel Anomalies; Dose-Response Relationship, Drug; Female; Humans; Intraoperative Complications; Male; Middle Aged; Operative Time; Outcome and Process Assessment (Health Care); Percutaneous Coronary Intervention; Radiation Monitoring; Risk Factors; United States