eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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SCImago Journal & Country Rank
4/2020
vol. 16
 
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abstract:
Original paper

Five-year report from the Polish national registry on percutaneous coronary interventions with a focus on coronary artery perforations within chronic total occlusions

Rafał Januszek
1, 2
,
Leszek Bryniarski
1, 3
,
Zbigniew Siudak
4
,
Krzysztof P. Malinowski
5
,
Krzysztof L. Bryniarski
6
,
Andrzej Surdacki
1
,
Artur Dziewierz
1, 3
,
Piotr Mika
2
,
Wojciech Wańha
7
,
Wojciech Wojakowski
7
,
Jarosław Wójcik
8
,
Jacek Legutko
6
,
Stanisław Bartuś
1, 3

1.
Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
2.
Department of Clinical Rehabilitation, University School of Physical Education, Krakow, Poland
3.
Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
4.
Collegium Medicum, Jan Kochanowski University, Kielce, Poland
5.
Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
6.
Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland
7.
Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
8.
Department of Cardiology, Hospital of Invasive Cardiology IKARDIA, Nałęczów, Poland
Adv Interv Cardiol 2020; 16, 4 (62): 399–409
Online publish date: 2021/01/05
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Aim
To assess the frequency of periprocedural complications with particular emphasis on coronary artery perforations (CAPs) among patients treated with PCIs stratified according to CTOs and their predictors.

Material and methods
Based on a nationwide registry (ORPKI), we analysed 535,853 patients treated with PCI between 2014 and 2018. The study included 12,572 (2.34%) patients treated with CTO PCI. We compared CTO PCI to a non-CTO PCI group before and after propensity score matching (PSM). Multifactorial mixed regression models were used to assess predictors of periprocedural complications and CAPs which occurred within the catheterization laboratory.

Results
Frequencies of all periprocedural complications (2.75% vs. 1.93%, p < 0.001) and CAP (0.72% vs. 0.16%, p < 0.001) were significantly higher in the CTO PCI group. Multifactorial regression analysis performed in the all-comers group of patients treated with PCI showed that PCI within CTO was related to a higher CAP rate (odds ratio (OR) = 2.18; 95% confidence interval (CI): 1.68–2.82, p < 0.001). After PSM, we extracted 5,652 patients treated within CTO and 5,652 patients with non-CTO PCI. CTO PCI was also related to a higher frequency of CAPs (OR = 1.89; 95% CI: 1.11–3.31, p = 0.01).

Conclusions
The frequency of periprocedural complications and CAPs remained stable during the assessed period of time. CTO PCI was confirmed to be among the predictors of increased CAP rate in the overall group of patients treated within CTO.

keywords:

chronic total occlusion, coronary artery perforations, percutaneous coronary intervention, periprocedural complications

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