TCT CONNECT-230 The Impact of Laser Use on the Outcomes of Balloon Uncrossable and Balloon Undilatable Chronic Total Occlusion Percutaneous Coronary Intervention
Karacsonyi J, Alaswad K, Choi J, Khatri J, Jaffer FA, Poomipanit P, Forouzandeh F, Koutouzis M, Tsiafoutis I, Patel M, Mahmud E, Krestyaninov O, Jefferson B, Patel T, Shah A, Chandwaney R, Wollmuth J, Sheikh A, Yeh R, Tamez H, Jaber W, Samady H, Malik B, Potluri S, Uretsky B, Doing A, Dattilo P, Elbarouni B, Love M, Vemmou E, Nikolakopoulos I, Xenogiannis I, Rangan B, Garcia S, Ungi I, ElGuindy A, Goktekin O, Rafeh NA, and Brilakis E. TCT CONNECT-230 The Impact of Laser Use on the Outcomes of Balloon Uncrossable and Balloon Undilatable Chronic Total Occlusion Percutaneous Coronary Intervention. Journal of the American College of Cardiology 2020; 76(17):B101-B102.
Journal of the American College of Cardiology
Background: We sought to examine the impact of laser use on the outcomes of balloon uncrossable and balloon undilatable chronic total occlusions (CTO) undergoing percutaneous coronary intervention (PCI).
Methods: The baseline clinical and angiographic characteristics and procedural outcomes of 4,845 CTO PCIs performed between 2012 and 2020 at 32 international centers were examined.
Results: Of the 4,845 CTOs 752 (15.5%), there were balloon uncrossable or balloon undilatable that were included in the further analyses. Mean patient age was 66.9 ± 10 years and 83% were men, with 51% prevalence of diabetes mellitus. Laser was used in 20.3% of the lesions. Compared with cases in which laser was not used, laser use was associated with longer occlusion length (33 [21, 50] vs. 25 [15, 40] mm, p = 0.0004) and in-stent restenotic lesions (41% vs. 20%, p < 0.0001). Laser use was associated with higher technical (91.5% vs. 83.1%, p = 0.010) and procedural (88.9% vs. 81.6%, p = 0.033) success rates and similar incidence of major cardiac adverse events (3.92% vs. 3.51%, p = 0.805). Laser use was also associated with longer procedural (169 [109, 231] vs. 130 [87, 199], p < 0.0001) and fluoroscopy time (64 [40, 94] vs. 50 [31, 81], p = 0.003). [Formula presented]
Conclusion: In a contemporary, multicenter registry balloon uncrossable and balloon undilatable lesions represented 15.5% of the CTO PCIs. Laser was used in approximately one-fifth of these cases. Use of laser was associated with higher technical and procedural success and similar major complication rates.
Categories: CORONARY: Complex and Higher Risk Procedures for Indicated Patients (CHIP)