Mechanical Circulatory Support in Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Multicenter US Registry
Danek BA, Basir MB, O'Neill WW, Alqarqaz M, Karatasakis A, Karmpaliotis D, Jaffer FA, Yeh RW, Wyman M, Lombardi WL, Kandzari D, Lembo N, Doing A, Patel M, Mahmud E, Choi JW, Toma C, Moses JW, Kirtane A, Parikh M, Ali ZA, Garcia S, Karacsonyi J, Rangan BV, Thompson CA, Banerjee S, Brilakis ES, Alaswad K. Mechanical circulatory support in chronic total occlusion percutaneous coronary intervention: Insights from a multicenter U.S. Registry. J Invasive Cardiol.
The Journal of invasive cardiology
OBJECTIVE: To study outcomes with use of percutaneous mechanical circulatory support (MCS) devices in chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
METHODS: We examined characteristics and outcomes of 1598 CTO-PCIs performed from 2012-2017 at 12 high-volume centers.
RESULTS: Patient age was 66 ± 10 years; 86% were men. An MCS device was used electively in 69 procedures (4%) and urgently in 22 procedures (1%). The most commonly used elective MCS device was Impella 2.5 or CP (62%). Compared to patients without elective MCS, patients with elective MCS had higher prevalence of prior heart failure (55% vs 29%; P
CONCLUSION: Elective MCS was used in 4% of patients undergoing CTO-PCI. Despite more complex clinical and angiographic characteristics, elective use of MCS in high-risk patients is associated with similar technical and procedural success rates, but higher risk of complications, compared to cases without elective MCS.
Medical Subject Headings
Aged; Assisted Circulation; Chronic Disease; Coronary Occlusion; Female; Hemodynamics; Humans; Male; Middle Aged; Outcome and Process Assessment (Health Care); Percutaneous Coronary Intervention; Registries; Secondary Prevention; Severity of Illness Index; United States