TCT-407 Clinical Characteristics and Outcomes of Impella-Supported High-Risk Percutaneous Coronary Intervention in Patients With Chronic Total Occlusion: Insights From the cVAD PROTECT III Registry
Recommended Citation
Falah B, Thompson J, Basir MB, Moses J, Redfors B, Schonning M, O’Neill W, Wollmuth J. TCT-407 Clinical Characteristics and Outcomes of Impella-Supported High-Risk Percutaneous Coronary Intervention in Patients With Chronic Total Occlusion: Insights From the cVAD PROTECT III Registry. J Am Coll Cardiol 2024; 84(18):B118.
Document Type
Conference Proceeding
Publication Date
10-29-2024
Publication Title
J Am Coll Cardiol
Abstract
Background: Patients (pts) with chronic coronary total occlusion (CTO) have high-risk features and greater procedural risk. Little is known about CTO pts receiving Impella-supported high-risk percutaneous coronary intervention (HRPCI). Methods: Baseline clinical and angiographic characteristics, procedural complications, and outcomes in pts with and without coronary CTOs who received Impella-supported HRPCI in the cVAD PROTECT III study (NCT04136392) were evaluated. CTO was defined as at least 1 coronary lesion with Thrombolysis In Myocardial Infarction (TIMI) grade 0 flow by independent angiographic core lab assessment. Major adverse cardiovascular and cerebrovascular events (MACCE: composite of all-cause death, myocardial infarction, stroke/transient ischemic attack, and repeat revascularization) were assessed by a clinical events committee at 30 and 90 days. Results: Of 1,237 pts enrolled in the cVAD PROTECT III study, 1,019 had angiographic core lab TIMI flow assessment; 12.6% had CTO, of which 58.5% were successfully revascularized. Patients with CTOs had longer procedures (2.4 vs 2.0 h, P = 0.0002), higher pre-PCI SYNTAX scores (31.2 vs 27.5, p = 0.004), longer lesions (18.5 vs 13.7 mm, P < 0.0001), and more lesions treated (2.7 vs 2.5, P = 0.04). There was no significant difference in PCI-related intraprocedural complications between groups. MACCE rates at 30 and 90 days were comparable between groups (P = 0.23 and P = 0.36, respectively). [Formula presented] Conclusion: Results from PROTECT III indicate that pts with a CTO undergoing Impella-supported HRPCI have higher anatomical complexity, but comparable periprocedural and acute outcomes as those without CTO. Categories: CORONARY: Complex and Higher Risk Procedures for Indicated Patients (CHIP).
Volume
84
Issue
18
First Page
B118
