Complications of chronic total occlusion percutaneous coronary intervention

Abstract

Chronic total occlusion percutaneous coronary interventions can be highly complex and are associated with an increased risk of complications, such as perforation, acute vessel closure (which can lead to rapid haemodynamic compromise if it involves the donor vessel), and equipment loss or entrapment. Awareness of the potential complications and meticulous attention to equipment position and patient monitoring can help minimise the risk of complications and allow prompt treatment should they occur.

International percutaneous coronary intervention complication survey

“…While overall ICs had high confidence in the placement of MCS devices, they believe that “the more you do it, the more comfortable you feel doing it.” A large proportion of participants (62%) use complication management algorithms that can expedite and streamline care and reduce the omission of critical steps 6–8 . The algorithmic approach to complications could facilitate a logical and systematic response that could alleviate stress and optimize patient outcomes 7–10 . Moreover, having a dedicated complication cart equipped with covered stents, coils, snares, pericardiocentesis tray, and performing practice sessions with the catheterization laboratory personnel could optimize the response to complications.…”

Lesion characteristics and procedural complications of chronic total occlusion percutaneous coronary intervention in patients with prior bypass surgery: A meta‐analysis

“…Although the success rate for it has improved year by year with the development of new techniques and available devices, the procedural complication is still an unavoidable risk. 33 In our meta-analysis, we analyzed four main complications those are perforation with the need for intervention, tamponade, major bleeding, and contrast-induced nephropathy. And to our pleasant surprise, the procedural complications are rare in both groups and the rates of complications in the prior CABG group remain comparable to patients in the non-CABG group.…”

“…The CTO‐PCI is considered as one of the last frontiers for interventional cardiologists. Although the success rate for it has improved year by year with the development of new techniques and available devices, the procedural complication is still an unavoidable risk 33 . In our meta‐analysis, we analyzed four main complications those are perforation with the need for intervention, tamponade, major bleeding, and contrast‐induced nephropathy.…”

Recanalisation of coronary chronic total occlusions

“…Furthermore, scores mostly attribute the same points to all the statistically significant predictive variables, irrespective of the magnitude. We encourage keeping generic percentages in the consent form, with percentages of success ranging between 70 and 95% and major complications between 0.1% and 5% [111][112][113][114][115][116] . This will allow the operator to adjust the estimates to the specific anatomy of the occlusion and his/her expectations of success in reopening the vessel.…”