Title

Frequency and Outcomes of Ad Hoc Versus Planned Chronic Total Occlusion Percutaneous Coronary Intervention: Multicenter Experience.

Document Type

Article

Publication Date

5-1-2019

Publication Title

The Journal of invasive cardiology

Abstract

BACKGROUND: For patients needing coronary chronic total occlusion (CTO) percutaneous coronary intervention (PCI), a planned, staged intervention has been recommended by experts. Ad hoc CTO-PCI, however, occurs in practice.

METHODS: Observational, contemporary, multicenter, international registry. Our goals were to determine the frequency, characteristics, procedural techniques, and outcomes of patients who underwent ad hoc vs planned CTO-PCI.

RESULTS: Among 2282 patients who underwent CTO-PCI between 2012 and 2017, 318 (14%) were ad hoc. Patients undergoing ad hoc CTO-PCI had lower J-CTO, PROGRESS CTO, and PROGRESS Complications scores. Antegrade-wire escalation was used more often in ad hoc PCI (96% vs 81%; P

CONCLUSIONS: Ad hoc CTO-PCI occurs more commonly in less complex lesions and is associated with similarly high success rates as planned CTO-PCI in lower J-CTO score lesions, suggesting that ad hoc CTO-PCI may be an acceptable option for experienced hybrid operators in carefully selected cases. Complex cases, as quantified by the J-CTO score, have a higher in-hospital MACE rate and should preferably be performed following proper planning and preparation.

Medical Subject Headings

Aged; Coronary Angiography; Coronary Occlusion; Coronary Vessels; Emergency Medical Services; Female; Humans; Male; Middle Aged; Outcome and Process Assessment, Health Care; Patient Care Planning; Percutaneous Coronary Intervention; Registries; Risk Adjustment; Risk Assessment; Severity of Illness Index; Time-to-Treatment

PubMed ID

30643040

Volume

31

Issue

5

First Page

133

Last Page

139

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