TCT-427 Impact of Interventional Collaterals on the Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention
Recommended Citation
Rempakos A, Alexandrou M, Mutlu D, Choi J, Khatri J, Davies R, Benton S, Gorgulu S, Jaffer F, Ybarra L, Azzalini L, Chandwaney R, Goktekin O, Bagur R, Rafeh NA, Khelimskii D, Rinfret S, Jaber W, Krestyaninov O, Nicholson W, Potluri S, Al-Azizi K, Alaswad K, Rangan B, Mastrodemos O, Allana S, Al-Ogaili A, Sandoval Y, Burke MN, Brilakis E, Poommipanit P. TCT-427 Impact of Interventional Collaterals on the Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention. J Am Coll Cardiol 2023; 82(17 Suppl):B171-B172.
Document Type
Conference Proceeding
Publication Date
10-24-2023
Publication Title
J Am Coll Cardiol
Keywords
adult, chronic total occlusion, conference abstract, confounding variable, controlled study, female, fluoroscopy, human, major adverse cardiac event, major clinical study, male, outcome assessment, percutaneous coronary intervention, perforation, risk assessment
Abstract
Background: The impact of interventional collaterals on the procedural techniques and outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. Methods: We examined the clinical and angiographic characteristics and procedural outcomes of 11,205 patients who underwent 11,444 CTO PCIs at 45 U.S. and non-U.S. centers between 2012 and 2023. Results: Interventional collaterals were present in 6,553 (57%) CTO PCI cases. Compared with lesions with interventional collaterals, lesions without interventional collaterals had lower J-CTO score (2.3 ± 1.3 vs 2.4 ± 1.3; P < 0.001). In 126 (2.6%) cases, retrograde was the successful crossing strategy, despite the absence of interventional collaterals. Cases with interventional collaterals were more likely to require longer procedure (122 vs 100 min; P<0.001) and fluoroscopy (48 vs 36 min; P < 0.001) time. The presence of interventional collaterals was associated with higher technical (88.4% vs 84.1%; P < 0.001) and procedural (86.8% vs 83.2%; P < 0.001) success, but also slightly more major adverse cardiovascular events (MACE) (2.3% vs 1.5%; P = 0.004). Perforations were also more common in the presence of interventional collaterals (5.4 % vs 3.9%; P < 0.001). After adjusting for potential confounders, the presence of interventional collaterals was associated with higher technical success and no difference in MACE. [Formula presented] Conclusion: The presence of interventional collaterals is independently associated with higher rates of technical success in CTO PCI. Categories: CORONARY: Complex and Higher Risk Procedures for Indicated Patients (CHIP)
Volume
82
Issue
17 Suppl
First Page
B171-B172
