TCT-98 Calcium Modification Strategies in Dissection and Re-Entry Versus Wiring Techniques in Chronic Total Occlusion Percutaneous Coronary Intervention
Recommended Citation
Mutlu D, Kostantinis S, Bagur R, Rempakos A, Simsek B, Karacsonyi J, Allana S, Alexandrou M, Gorgulu S, Alaswad K, Basir MB, Davies R, Krestyaninov O, Khelimskii D, Frizzell J, Love M, Elbarouni B, Patel M, Mahmud E, Jaber W, Rinfret S, Nicholson W, ElGuindy A, Goktekin O, Mastrodemos O, Rangan B, Sandoval Y, Burke MN, Brilakis E, Ybarra L. TCT-98 Calcium Modification Strategies in Dissection and Re-Entry Versus Wiring Techniques in Chronic Total Occlusion Percutaneous Coronary Intervention. J Am Coll Cardiol 2023; 82(17 Suppl):B38-B39.
Document Type
Conference Proceeding
Publication Date
10-24-2023
Publication Title
J Am Coll Cardiol
Keywords
calcium, adult, atherectomy, balloon, chronic total occlusion, conference abstract, controlled study, dissection, female, human, incidence, laser, lithotripsy, major adverse cardiac event, major clinical study, male, multicenter study, percutaneous coronary intervention, perforation, risk assessment, rotational atherectomy, surgery
Abstract
Background: The use of calcium modification strategies in dissection and re-entry compared with wiring techniques in chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. Methods: We analyzed the procedural outcomes of 1,241 CTO PCIs that required the use of 1 or more calcium modification strategies at 42 centers from 2012 to 2023. Results: A calcium modification strategy was used as part of a dissection and re-entry strategy in 23% and as part of wiring technique in 77%. The most common calcium modification strategy in the dissection and re-entry group was scoring balloon (29.5%) and rotational atherectomy (29.5%), followed by laser atherectomy (20.7%) and intravascular lithotripsy (IVL) (18.3%). In the wiring group, rotational atherectomy (38.3%) was the most frequently used calcium modification therapy, followed by laser atherectomy (25.8%), IVL (17.8%), and scoring balloon (15.3%). Technical success was overall similar (95.1% vs 96.9%; P = 0.155) in the 2 groups, but was higher when IVL (100.0% vs 96.2%; P = 0.011) or scoring balloon (98.6% vs 94.0%; P = 0.049) was used in wiring cases. The incidence of major adverse cardiovascular events (MACE) was higher in the dissection and re-entry group (5.3% vs 2.4%; P = 0.014), especially among cases where scoring balloon (8.4% vs 2.1%; P = 0.023) or rotational atherectomy (9.5% vs 3.6%; P = 0.019) was used. [Formula presented] Conclusion: The use of calcium modification strategies in dissection and re-entry was associated with similar technical success but higher incidence of MACE and perforation compared with wiring techniques. Categories: CORONARY: Complex and Higher Risk Procedures for Indicated Patients (CHIP)
Volume
82
Issue
17 Suppl
First Page
B38-B39
