Abstract
BackgroundSuccessful management of chronic total occlusion (CTO)by percutaneous coronary intervention (PCI) is known to be associated with better clinical outcomes than failed PCI. However, whether angiographic and clinical outcomes following PCI for long CTO lesions differ from those following PCI for short CTO lesions in the drug eluting stent (DES) era remains unknown. We therefore investigated whether CTO lesion length can significantly influence6-month angiographic and 2-year clinical outcomes following successful CTO PCI.Methods and resultsA total of 235 consecutive patients who underwent successful CTO intervention were allocated into either the long or short CTO group according to CTO lesion length. Six-month angiographic and 2-year clinical outcomes were then compared between the 2groups. We found that baseline clinical characteristics were generally similar between the 2 groups. Exceptions were prior PCI, which was more frequent in the long CTO group, and bifurcation lesions, which were more frequent in the short CTO group. Apart from intimal dissection, which was more frequent in the long than short CTO group, in-hospital complications were also similarly frequent between the 2groups. Furthermore, both groups had similar angiographic outcomes at 6 months and clinical outcomes at 2 years. However, the incidence of repeat PCI(predominantly target vessel revascularization),was higher in the long than short CTO group, with our multivariate analysis identifying long CTO as an important predictor of repeat PCI (odds ratio, 4.26;95% confidence interval, 1.53–11.9; p = 0.006).ConclusionThe safety profile, 6-month angiographic, and 2-year clinical outcomes of CTO PCI were similar between patients with long and short CTO. However, there was a higher incidence of repeat PCI in long CTO patients despite successful PCI with DESs.
Highlights
The use of drug-eluting stents (DESs) and development of devices for the management of coronary artery stenosis have resulted in the reduction of restenosis and adverse events following intervention[1]
Despite reductions in restenosis due to DES use, clinical outcomes following percutaneous coronary intervention (PCI) in particular remain strongly affected by baseline lesion characteristics, with greater coronary artery lesion length being associated with poorer prognosis after PCI[2,3,4,5].despite remarkable progress in the development of DESs, as well as in the development of special devices and techniques for chronic total occlusion (CTO) PCI, procedural success rates in CTO patients are still lower than those in non-CTO patients, with long term outcomes in the former thought to be affected by baseline lesion characteristics as well as other clinical risk factors[6].It should be noted, that lesion characteristics such as the development of collateral vessels differ between CTO and non-CTO patients
A total of 235CTO patients who underwent PCI using DESs were enrolled in this study
Summary
The use of drug-eluting stents (DESs) and development of devices for the management of coronary artery stenosis have resulted in the reduction of restenosis and adverse events following intervention[1]. Despite reductions in restenosis due to DES use, clinical outcomes following percutaneous coronary intervention (PCI) in particular remain strongly affected by baseline lesion characteristics, with greater coronary artery lesion length being associated with poorer prognosis after PCI[2,3,4,5].despite remarkable progress in the development of DESs, as well as in the development of special devices and techniques for chronic total occlusion (CTO) PCI, procedural success rates in CTO patients are still lower than those in non-CTO patients, with long term outcomes in the former thought to be affected by baseline lesion characteristics as well as other clinical risk factors[6].It should be noted, that lesion characteristics such as the development of collateral vessels differ between CTO and non-CTO patients. We investigated whether CTO lesion length can significantly influence6month angiographic and 2-year clinical outcomes following successful CTO PCI.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
