Gustavo M. Hirata MD, Athanasios Rempakos MD, A. Walker Boyd MD, Michaella Alexandrou MD, Deniz Mutlu MD, James W. Choi MD, Paul Poommipanit MD, Jaikirshan J. Khatri MD, Laura Young MD, Rhian Davies DO, MS, Sevket Gorgulu MD, Farouc A. Jaffer MD, PhD, Raj Chandwaney MD, Brian Jefferson MD, Basem Elbarouni MD, Lorenzo Azzalini MD, PhD, MSc, Kathleen E. Kearney MD, Khaldoon Alaswad MD, Mir B. Basir DO, Oleg Krestyaninov MD, Dmitrii Khelimskii MD, Nazif Aygul MD, Nidal Abi-Rafeh MD, Ahmed ElGuindy MD, Omer Goktekin MD, Bavana V. Rangan BDS, MPH, Olga C. Mastrodemos BA, Ahmed Al-Ogaili MD, Yader Sandoval MD, M. Nicholas Burke MD, Emmanouil S. Brilakis MD, Jarrod D. Frizzell MD
{"title":"异常冠状动脉的慢性全闭塞经皮冠状动脉介入治疗：PROGRESS CTO 登记的启示。","authors":"Gustavo M. Hirata MD, Athanasios Rempakos MD, A. Walker Boyd MD, Michaella Alexandrou MD, Deniz Mutlu MD, James W. Choi MD, Paul Poommipanit MD, Jaikirshan J. Khatri MD, Laura Young MD, Rhian Davies DO, MS, Sevket Gorgulu MD, Farouc A. Jaffer MD, PhD, Raj Chandwaney MD, Brian Jefferson MD, Basem Elbarouni MD, Lorenzo Azzalini MD, PhD, MSc, Kathleen E. Kearney MD, Khaldoon Alaswad MD, Mir B. Basir DO, Oleg Krestyaninov MD, Dmitrii Khelimskii MD, Nazif Aygul MD, Nidal Abi-Rafeh MD, Ahmed ElGuindy MD, Omer Goktekin MD, Bavana V. Rangan BDS, MPH, Olga C. Mastrodemos BA, Ahmed Al-Ogaili MD, Yader Sandoval MD, M. Nicholas Burke MD, Emmanouil S. Brilakis MD, Jarrod D. Frizzell MD","doi":"10.1002/ccd.31248","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>There is limited information about the frequency and outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in anomalous coronary arteries (ACA).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We examined the clinical and angiographic characteristics and procedural outcomes of CTO PCI in ACA among 14,173 patients who underwent 14,470 CTO PCIs at 46 US and non-US centers between 2012 and 2023.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Of 14,470 CTO PCIs, 36 (0.24%) were CTO PCIs in an ACA. ACA patients had similar baseline characteristics as those without an ACA. The type of ACA in which the CTO lesion was found were as follows: anomalous origin of the right coronary artery (ARCA) (17, 48.5%), anomalous origin of left circumflex coronary artery (9, 25.7%), left anterior descending artery and left circumflex artery with separate origins (4, 11.4%), anomalous origin of the left anterior descending artery (2, 5.7%), dual left anterior descending artery (2, 5.7%) and woven coronary artery 1 (2.8%). The Japan CTO score was similar between both groups (2.17 ± 1.32 vs 2.38 ± 1.26, <i>p</i> = 0.30). The target CTO in ACA patients was more likely to have moderate/severe tortuosity (44% vs 28%, <i>p</i> = 0.035), required more often use of retrograde approach (27% vs 12%, <i>p</i> = 0.028), and was associated with longer procedure (142.5 min vs 112.00 min [74.0, 164.0], <i>p</i> = 0.028) and fluoroscopy (56 min [40, 79 ml] vs 42 min [25, 67], <i>p</i> = 0.014) time and higher contrast volume (260 ml [190, 450] vs 200 ml [150, 300], <i>p</i> = 0.004) but had similar procedural (91.4% vs 85.6%, <i>p</i> = 0.46) and technical (91.4% vs 87.0%, <i>p</i> = 0.59) success. No major adverse cardiac events (MACE) were seen in ACA patients (0% [0] vs 1.9% [281] in non-ACA patients, <i>p</i> = 1.00). Two coronary perforations were reported in ACA CTO PCI (<i>p</i> = 0.7 vs. non-ACA CTO PCI).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>CTO PCI of ACA comprise 0.24% of all CTO PCIs performed in the PROGRESS CTO registry and was associated with higher procedural complexity but similar technical and procedural success rates and similar MACE compared with non-ACA CTO PCI.</p>\n </section>\n </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"104 6","pages":"1148-1158"},"PeriodicalIF":2.1000,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Chronic total occlusion percutaneous coronary intervention of anomalous coronary arteries: insights from the PROGRESS CTO registry\",\"authors\":\"Gustavo M. Hirata MD, Athanasios Rempakos MD, A. Walker Boyd MD, Michaella Alexandrou MD, Deniz Mutlu MD, James W. Choi MD, Paul Poommipanit MD, Jaikirshan J. Khatri MD, Laura Young MD, Rhian Davies DO, MS, Sevket Gorgulu MD, Farouc A. Jaffer MD, PhD, Raj Chandwaney MD, Brian Jefferson MD, Basem Elbarouni MD, Lorenzo Azzalini MD, PhD, MSc, Kathleen E. Kearney MD, Khaldoon Alaswad MD, Mir B. Basir DO, Oleg Krestyaninov MD, Dmitrii Khelimskii MD, Nazif Aygul MD, Nidal Abi-Rafeh MD, Ahmed ElGuindy MD, Omer Goktekin MD, Bavana V. Rangan BDS, MPH, Olga C. Mastrodemos BA, Ahmed Al-Ogaili MD, Yader Sandoval MD, M. Nicholas Burke MD, Emmanouil S. Brilakis MD, Jarrod D. Frizzell MD\",\"doi\":\"10.1002/ccd.31248\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>There is limited information about the frequency and outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in anomalous coronary arteries (ACA).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We examined the clinical and angiographic characteristics and procedural outcomes of CTO PCI in ACA among 14,173 patients who underwent 14,470 CTO PCIs at 46 US and non-US centers between 2012 and 2023.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Of 14,470 CTO PCIs, 36 (0.24%) were CTO PCIs in an ACA. ACA patients had similar baseline characteristics as those without an ACA. The type of ACA in which the CTO lesion was found were as follows: anomalous origin of the right coronary artery (ARCA) (17, 48.5%), anomalous origin of left circumflex coronary artery (9, 25.7%), left anterior descending artery and left circumflex artery with separate origins (4, 11.4%), anomalous origin of the left anterior descending artery (2, 5.7%), dual left anterior descending artery (2, 5.7%) and woven coronary artery 1 (2.8%). The Japan CTO score was similar between both groups (2.17 ± 1.32 vs 2.38 ± 1.26, <i>p</i> = 0.30). The target CTO in ACA patients was more likely to have moderate/severe tortuosity (44% vs 28%, <i>p</i> = 0.035), required more often use of retrograde approach (27% vs 12%, <i>p</i> = 0.028), and was associated with longer procedure (142.5 min vs 112.00 min [74.0, 164.0], <i>p</i> = 0.028) and fluoroscopy (56 min [40, 79 ml] vs 42 min [25, 67], <i>p</i> = 0.014) time and higher contrast volume (260 ml [190, 450] vs 200 ml [150, 300], <i>p</i> = 0.004) but had similar procedural (91.4% vs 85.6%, <i>p</i> = 0.46) and technical (91.4% vs 87.0%, <i>p</i> = 0.59) success. No major adverse cardiac events (MACE) were seen in ACA patients (0% [0] vs 1.9% [281] in non-ACA patients, <i>p</i> = 1.00). Two coronary perforations were reported in ACA CTO PCI (<i>p</i> = 0.7 vs. non-ACA CTO PCI).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>CTO PCI of ACA comprise 0.24% of all CTO PCIs performed in the PROGRESS CTO registry and was associated with higher procedural complexity but similar technical and procedural success rates and similar MACE compared with non-ACA CTO PCI.</p>\\n </section>\\n </div>\",\"PeriodicalId\":9650,\"journal\":{\"name\":\"Catheterization and Cardiovascular Interventions\",\"volume\":\"104 6\",\"pages\":\"1148-1158\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-10-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Catheterization and Cardiovascular Interventions\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/ccd.31248\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Catheterization and Cardiovascular Interventions","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ccd.31248","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Chronic total occlusion percutaneous coronary intervention of anomalous coronary arteries: insights from the PROGRESS CTO registry
Background
There is limited information about the frequency and outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in anomalous coronary arteries (ACA).
Methods
We examined the clinical and angiographic characteristics and procedural outcomes of CTO PCI in ACA among 14,173 patients who underwent 14,470 CTO PCIs at 46 US and non-US centers between 2012 and 2023.
Results
Of 14,470 CTO PCIs, 36 (0.24%) were CTO PCIs in an ACA. ACA patients had similar baseline characteristics as those without an ACA. The type of ACA in which the CTO lesion was found were as follows: anomalous origin of the right coronary artery (ARCA) (17, 48.5%), anomalous origin of left circumflex coronary artery (9, 25.7%), left anterior descending artery and left circumflex artery with separate origins (4, 11.4%), anomalous origin of the left anterior descending artery (2, 5.7%), dual left anterior descending artery (2, 5.7%) and woven coronary artery 1 (2.8%). The Japan CTO score was similar between both groups (2.17 ± 1.32 vs 2.38 ± 1.26, p = 0.30). The target CTO in ACA patients was more likely to have moderate/severe tortuosity (44% vs 28%, p = 0.035), required more often use of retrograde approach (27% vs 12%, p = 0.028), and was associated with longer procedure (142.5 min vs 112.00 min [74.0, 164.0], p = 0.028) and fluoroscopy (56 min [40, 79 ml] vs 42 min [25, 67], p = 0.014) time and higher contrast volume (260 ml [190, 450] vs 200 ml [150, 300], p = 0.004) but had similar procedural (91.4% vs 85.6%, p = 0.46) and technical (91.4% vs 87.0%, p = 0.59) success. No major adverse cardiac events (MACE) were seen in ACA patients (0% [0] vs 1.9% [281] in non-ACA patients, p = 1.00). Two coronary perforations were reported in ACA CTO PCI (p = 0.7 vs. non-ACA CTO PCI).
Conclusions
CTO PCI of ACA comprise 0.24% of all CTO PCIs performed in the PROGRESS CTO registry and was associated with higher procedural complexity but similar technical and procedural success rates and similar MACE compared with non-ACA CTO PCI.
期刊介绍：
Catheterization and Cardiovascular Interventions is an international journal covering the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability.
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