Analiza izvajanja perkutanih koronarnih posegov v 10-letnem obdobju (2005–2015) – izkušnje enega centra

Abstract

Background: Medicor was established as the third cardiovascular center in Slovenia and started with percutaneous cardiovascular interventions in 2005. The purpose of our study was to describe the features and results of percutaneous coronary intervention (PCI) performed between 2005 and 2015.Methods: Our retrospective descriptive study included consecutive patients undergoing PCI, who were enrolled in the PCI Registry. Patient characteristics, coronary anatomy, PCI features, use of coronary stents, procedural success and complications were investigated. Special emphasis was put on patients undergoing unprotected left main PCI.Results: During the study period, 1981 PCI procedures were performed. PCI patients were mainly men (73 %), their average age was 65+10 years and a majority (94 %) had stable coronary disease with mutivessel involvement (62 %). PCI was performed on 2978 lesions (1.50 lesion/patient) with an average diameter stenosis of 85+10 %. Target lesion was located either in the left anterior descending artery (42.9 %), right coronary artery (32.4 %), left circumflex artery (18.4 %), left main (3 %), surgical grafs (2.3 %) or in the intermediate artery (1 %). Balloon angioplasty alone was used in 9.6 % while other patients received 1 to 7 stents (1.44+0.86 per patient). Until 2009, drug eluting stents (DES) penetration ranged between 20 % and 30 %. It then increased to 80 % in 2012 and 100 % in 2015. PCI was angiographically successful in 95.2 %. Because of PCI complications, 4 patients (0.2 %) required immediate open-heart surgery and 4 patients (0.2 %) a surgical intervention at the femoral access site. Hospital mortality was 0 %. Stent thrombosis within 30 days was documented in 6 patients (0.3 %). In a subgroup of 58 patients undergoing unprotected lef main PCI, provisional stenting was used in 88 %. DES penetration was 94 %. PCI was angiografcally successful in all patients. Hospital and 30-day mortality rates were 0 %, 1-year mortality 1.7 % (95 % confidence interval 0–11 %) and 5-year mortality 13.8 % (95 % confidence interval 7–33 %). Target vessel revascularization at 5 years was 3.5 % (95 % confidence interval 0–23 %).Conclusion: PCI in patients with predominantly stable coronary artery disease in the Medicor Cardiovascular Center appears to be an effective and safe method of revascularization, which is also true for an intervention in unprotected left main.