eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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SCImago Journal & Country Rank
1/2019
vol. 15
 
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abstract:
Original paper

Differences in patients and lesion and procedure characteristics depending on the age of the coronary chronic total occlusion

Krzysztof L. Bryniarski, Gerald S. Werner, Kambis Mashayekhi, Jarosław Wójcik, David Hildick-Smith, George Sianos, Alfredo R. Galassi, Roberto Garbo, Carlo Di Mario, Kamil Fijorek, Nicolas Boudou, Nicolaus Reifart, Leszek Bryniarski

Adv Interv Cardiol 2019; 15, 1 (55): 28–41
Online publish date: 2019/01/21
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Introduction
Whether duration of chronic total occlusion (CTO) affects lesion and procedural characteristics remains largely unknown.

Aim
To investigate whether CTO duration influences lesion characteristics and revascularization success.

Material and methods
EuroCTO Registry data on patients who had CTO percutaneous coronary intervention between January 2015 and April 2017 were analyzed. Three groups were created based on occlusion age: 3 to 6 months (n = 1415), 7 to 12 months (n = 973), > 12 months (n = 1656).

Results
Patients with greater CTO duration were older (63.0 (56.0–70.0); 63.0 (56.0–71.0); 66.0 (59.0–73.0) years respectively; p < 0.001), had more 3-vessel disease (32.2%; 30.9%; 46.1% respectively; p < 0.001) and more frequent prior coronary artery bypass grafting (8.2%; 9.9%; 29.4% respectively; p < 0.001). In multivariate analysis, occlusion duration was associated with moderate/severe calcification (OR = 1.52; 95% CI: 1.28–1.80; p < 0.001), lesion length > 20 mm (OR 1.77; 95% CI 1.49–2.10; p < 0.001), and collateral circulation Werner type 2 (OR = 1.20; 95% CI: 1.01–1.43; p = 0.041). The CTO duration was associated with lower procedural success (OR for success 0.60; 95% CI: 0.46–0.79; p < 0.001). In multivariate analysis in-hospital adverse events did not differ according to duration of CTO.

Conclusions
Coronary artery CTO duration is associated with greater extent of calcification, lesion length, development of collateral circulation and, most importantly, with lower procedural success.

keywords:

chronic total occlusion, lesion characteristics, percutaneous coronary intervention

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