Impact of calcification length ratio on the intervention for chronic total occlusions

Hsu, Jen Te; Kyo, Eisho; Chu, Cordia; Tsuji, Takafumi; Watanabe, Satoshi

doi:10.1016/j.ijcard.2010.03.002

Cited by 57 publications

(32 citation statements)

References 24 publications

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“…However, our study's lesion length cutoff value of 31.89 mm is much longer than the 15-to 20-mm cutoff value reported previously(21,22). Other signs were not significant predictors of antegrade CTO success in our study, in contrast to previous studies(6,7). In addition to the fact that our study utilized coronary CTA and CCA, these findings might be partly explained by the recent development of interven-STUDY LIMITATIONS.…”

contrasting

confidence: 89%

“…Even the extremely-calcified CTOs had a slender portion of noncalcified residue in the lumen(Figure 2Ed), which is an important factor for successful recanalization. Using the increased resolution of 256-slice CT for coronary CTA, the noncalcified residue lumens of occluded arteries are more sensitively identified(6,7), and the operator could easily find the optimal anchor point and path to avoid calcification (Figure 2)(3).…”

mentioning

confidence: 99%

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Predictors of Interventional Success of Antegrade PCI for CTO

Luo

Huang

et al. 2015

JACC: Cardiovascular Imaging

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contrasting

confidence: 89%

mentioning

confidence: 99%

Predictors of Interventional Success of Antegrade PCI for CTO

Luo

Huang

et al. 2015

JACC: Cardiovascular Imaging

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“…26 Coronary intervention in elderly CTO patients may be more difficult than in younger CTO patients because of lesion complexity and susceptibility to transient ischemia. 27 Furthermore, elderly patients present a higher rate of complications, such as access site injury or additional transfusions, during and after the procedure. 28 In the case of CABG, intraoperative or postoperative MI, low cardiac output syndrome, stroke, gastrointestinal complications, wound infection and renal failure occur more frequently in elderly patients after cardiac surgery and predict adverse outcomes.…”

Section: Disclosures/competing Interests/grant Supportmentioning

confidence: 99%

Long-Term Clinical Outcomes of Medical Therapy for Coronary Chronic Total Occlusions in Elderly Patients (≥75 Years)

Lee

Yang

Choi

et al. 2015

Circ J

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Background: Limited data are available on the clinical outcomes of medical therapy (MT) compared with revascularization in elderly patients with coronary chronic total occlusion (CTO). Methods and Results:Between March 2003 and February 2012, we retrospectively analyzed 311 patients aged ≥75 years in the Samsung Medical Center CTO registry. Among these, 153 patients were treated with MT and 158 patients with revascularization by intervention or surgery. Inverse probability of treatment weighting (IPTW) and propensity score-matching were performed. The primary outcome was cardiac death during follow-up. Median followup duration was 34 (interquartile range: 15-58) months. Overall, patients in the MT group were high-risk subjects. Cardiac death of 30 patients (19.6%) occurred in the MT group vs. 17 patients (10.8%) in revascularization group (P=0.027). In the multivariate analysis, there was no significant difference between groups in the rate of cardiac death (hazard ratio [HR], 1.67; 95% confidence interval [CI], 0.86-3.24, P=0.13). After adjustment with IPTW, MT showed comparable risk of cardiac death with revascularization therapy (HR, 1.26; 95% CI, 0.71-2.21, P=0.43). In the propensity score-matched population, there was no significant difference in the rate of cardiac death between the MT and revascularization groups (HR, 1.52; 95% CI, 0.76-3.07, P=0.24). Conclusions:In the treatment of CTO in elderly patients, MT alone did not increase the risk of long-term cardiac death when compared with aggressive revascularization treatment. (Circ J 2015; 79: 1780 -1786

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“…Nearly 15-23% of patients who undergo coronary angiography (CCA) are CTOs, with success rates of only 55-90% [1][2][3][4][5]. DES has been shown to improve the outcome of coronary artery disease patients with DM or CTOs [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Durable polymer versus bioabsorbable polymer drug eluting stents in right coronary artery chronic total occlusions: Eighteen months (median) results of a single-center experience

Çiçek¹

2017

Interventional-Cardiology

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Objective: There are a few data regarding the long-term clinical outcomes of durable polymer (DP) drug-eluting stents (DES) versus bio absorbable polymer (BP) drug-eluting stents treatment in patients with right coronary artery (RCA) chronic total occlusion (CTO). The aim of this study was to compare the clinical outcomes of these stents according to their polymer-based difference. Methods:Between June 2013 and August 2016, 66 RCA CTO patients enrolled in the study. Fortyseven patients with successful CTO recanalization of RCA via ante grade or retrograde approach using either DP (n=25) and BP (n=22) were scheduled for 6, 12, and 18 months clinical follow-up. Primary clinical outcomes were cardiac death and major adverse cardiac events (MACE).Results: RCA CTO success rate was 71%. There was no difference in Japanese-CTO (JCTO) scores between two groups. Total stent length was longer in BP group, and it was statistically significant (p=0.015). The incidence of cardiac death was not significant between the two groups. After propensity score matching, TVR rates were 12.0% for DP group and 9.1% for BP group at the end of the 18th month (hazard ratio [HR] 182-4.718; p=0.927). Conclusion:This study shows that the efficacy of BP-DES is comparable to that second-generation DP-DES treatment for RCA CTO over 18-month follow-up.

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Impact of calcification length ratio on the intervention for chronic total occlusions

Cited by 57 publications

References 24 publications

Predictors of Interventional Success of Antegrade PCI for CTO

Predictors of Interventional Success of Antegrade PCI for CTO

Long-Term Clinical Outcomes of Medical Therapy for Coronary Chronic Total Occlusions in Elderly Patients (≥75 Years)

Durable polymer versus bioabsorbable polymer drug eluting stents in right coronary artery chronic total occlusions: Eighteen months (median) results of a single-center experience

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