Predictors of successful primary antegrade wiring in chronic total occlusion percutaneous coronary intervention.

IF 1.6 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Invasive Cardiology Pub Date : 2024-06-01 DOI:10.25270/jic/23.00305
Athanasios Rempakos, Michaella Alexandrou, Deniz Mutlu, James W Choi, Paul Poommipanit, Jaikirshan J Khatri, Laura Young, Philip Dattilo, Yasser Sadek, Rhian Davies, Sevket Gorgulu, Farouc A Jaffer, Raj Chandwaney, Brian Jefferson, Baseem Elbarouni, Lorenzo Azzalini, Kathleen E Kearney, Khaldoon Alaswad, Mir B Basir, Oleg Krestyaninov, Dmitrii Khelimskii, Nazif Aygul, Nidal Abi-Rafeh, Ahmed Elguindy, Omer Goktekin, Bavana V Rangan, Olga C Mastrodemos, Ahmed Al-Ogaili, Yader Sandoval, M Nicholas Burke, Emmanouil S Brilakis, Arun Kalyanasundaram
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引用次数: 0

Abstract

Background: Antegrade wiring is the most commonly used chronic total occlusion (CTO) crossing technique.

Methods: Using data from the PROGRESS CTO registry (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention; Clinicaltrials.gov identifier: NCT02061436), we examined the clinical and angiographic characteristics and procedural outcomes of CTO percutaneous coronary interventions (PCIs) performed using a primary antegrade wiring strategy.

Results: Of the 13 563 CTO PCIs performed at 46 centers between 2012 and 2023, a primary antegrade wiring strategy was used in 11 332 (83.6%). Upon multivariable logistic regression analysis, proximal cap ambiguity (odds ratio [OR]: 0.52; 95% CI, 0.46-0.59), side branch at the proximal cap (OR: 0.85; 95% CI, 0.77-0.95), blunt/no stump (OR: 0.52; 95% CI: 0.47-0.59), increasing lesion length (OR [per 10 mm increase]: 0.79; 95% CI, 0.76-0.81), moderate to severe calcification (OR: 0.73; 95% CI, 0.66-0.81), moderate to severe proximal tortuosity (OR: 0.67; 95% CI, 0.59-0.75), bifurcation at the distal cap (OR: 0.66; 95% CI, 0.59-0.73), left anterior descending artery CTO (OR [vs right coronary artery]: 1.44; 95% CI, 1.28-1.62) and left circumflex CTO (OR [vs right coronary artery]: 1.22; 95% CI, 1.07-1.40), non-in-stent restenosis lesion (OR: 0.56; 95% CI, 0.49-0.65), and good distal landing zone (OR: 1.18; 95% CI, 1.06-1.32) were independently associated with primary antegrade wiring crossing success.

Conclusions: The use of antegrade wiring as the initial strategy was high (83.6%) in our registry. We identified several parameters associated with primary antegrade wiring success.

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慢性全闭塞经皮冠状动脉介入治疗中一次前向接线成功的预测因素。
背景:前向布线是最常用的慢性全闭塞(CTO)穿越技术:前向布线是最常用的慢性全闭塞(CTO)穿越技术:利用 PROGRESS CTO 登记处(慢性全闭塞干预研究前瞻性全球登记处;Clinicaltrials.gov identifier:NCT02061436)的数据,我们研究了采用主要前行布线策略进行的CTO经皮冠状动脉介入治疗(PCI)的临床和血管造影特征以及手术结果:2012年至2023年期间,在46个中心进行的13 563例CTO PCI中,有11 332例(83.6%)采用了主要逆行布线策略。经多变量逻辑回归分析,近端帽模糊性(几率比 [OR]:0.52;95% CI:0.46-0.59)、近端帽侧支(OR:0.85;95% CI:0.77-0.95)、钝/无残端(OR:0.52;95% CI:0.47-0.59)、病变长度增加(OR [每增加 10 mm]:0.79;95% CI,0.76-0.81)、中度至重度钙化(OR:0.73;95% CI,0.66-0.81)、中度至重度近端迂曲(OR:0.67;95% CI,0.59-0.75)、远端冠状动脉分叉(OR:0.66;95% CI,0.59-0.73)、左前降支动脉 CTO(OR [vs 右冠状动脉]:1.44;95% CI,1.28-1.62)和左侧环状动脉 CTO(OR [vs 右冠状动脉]:1.22;95% CI,1.07-1.40)、非支架内再狭窄病变(OR:0.56;95% CI,0.49-0.65)和良好的远端着床区(OR:1.18;95% CI,1.06-1.32)与一次前行布线穿越成功独立相关:在我们的登记册中,使用前向布线作为初始策略的比例很高(83.6%)。我们发现了几个与初次逆行接线成功率相关的参数。
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来源期刊
Journal of Invasive Cardiology
Journal of Invasive Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.90
自引率
6.70%
发文量
214
审稿时长
3-8 weeks
期刊介绍: The Journal of Invasive Cardiology will consider for publication suitable articles on topics pertaining to the invasive treatment of patients with cardiovascular disease.
期刊最新文献
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