A contemporary review of clinical significances of percutaneous coronary intervention for chronic total occlusions, with some Japanese insights

Morino, Yoshihiro

doi:10.1007/s12928-021-00766-7

Cited by 1 publication

(2 citation statements)

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“…Coronary artery disease (CAD) has been identified as the leading cause of morbidity and mortality in developed countries [1][2][3] . Despite the availability of guideline-directed medical therapy (GDMT), a significant number of patients still require coronary revascularization including percutaneous coronary intervention (PCI) [4][5][6] . In the beginning of PCI, non-complex coronary lesions were often the main target, and complex coronary lesions were often referred to coronary artery bypass surgery (CABG) [7][8] .…”

Section: Introductionmentioning

confidence: 99%

“…Lastly, non-CHIP was defined as complex PCI with neither patient factors nor complicated heart disease. The primary aim of this study was to determine the major complications in PCI, which were defined as the composite of (1) in-hospital death, (2) cardiac tamponade requiring pericardial drainage, (3) emergent surgery, (4) stroke within 48 hours from PCI, (5) emergent use of mechanical circulatory support during PCI procedure, (6) periprocedural myocardial infarction (PMI), (7) puncture site complications requiring blood transfusion, (8) acute heart failure during PCI procedure, and (9) unsuccessful PCI to non-CTO lesions. Information regarding the above clinical outcomes were acquired from the hospital records.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Outcomes of Elective Percutaneous Coronary Intervention between Complex and High-Risk Intervention in Indicated Patients (CHIP) versus Non-CHIP

Fujimoto

Sakakura

Jinnouchi

et al. 2023

JAT

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Aims: Complex and high-risk intervention in indicated patients (CHIP) is an emerging concept in the contemporary percutaneous coronary intervention (PCI). CHIP is known to consist three factors, namely, (1) patient factors, (2) complicated heart disease, and (3) complex PCI. However, it remains unclear whether additional CHIP factors further increase the incidence of complications in complex PCI. Thus, in this study, we aim to compare the incidence of complications among definite CHIP, possible CHIP, and non-CHIP in terms of complex PCI and to further investigate the association between CHIP and complications. Methods:The primary aim of this study was to determine the major complications in PCI. We included 989 PCI lesions and divided those into definite CHIP (n=140), possible CHIP (n=397), and the non-CHIP groups (n=452). Results:The incidence of major complications was noted to be the highest in the definite CHIP, followed by the possible CHIP, and lowest in the non-CHIP (p=0.001). The multivariate logistic regression analysis using a generalized estimating equation revealed definite CHIP (versus non-CHIP: odds ratio (OR) 2.099, 95% confidence interval (CI) 1.062-4.150, p=0.033) was significantly associated with major complications after controlling for confounding factors. Another multivariate logistic regression analysis revealed immunosuppressive drugs (OR 3.040, 95% CI 1.251-7.386, p=0.014), unstable hemodynamics (OR 5.753, 95% CI 1.217-27.201, p=0.027), and frailty (OR 2.039, 95% CI 1.108-3.751, p=0.022) were significantly associated with major complications among CHIP factors. Conclusions:The incidence of major complications in complex PCI was determined to be the highest in the definite CHIP, followed by the possible CHIP and lowest in the non-CHIP. Thus, more attention should be given to the three components of CHIP to prevent major complications in complex PCI.

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