Chronic total occlusion percutaneous coronary intervention in Latin America. Issue 5 (28th January 2020)

• Record Type: Journal Article
• Authors: Quadros, Alexandre; Belli, Karlyse C.; de Paula, João E. T.; de Magalhães Campos, Carlos A. H.; da Silva, Antonio C. B.; Santiago, Ricardo; Ribeiro, Marcelo H.; de Oliveira, Pedro P.; Lamelas, Pablo; Abelin, Aníbal P.; Bezerra, Cristiano G.; Filho, Evandro M.; Fuchs, Felipe C.; de los Santos, Félix D.; de Andrade, Pedro B.; Quesada, Franklin L. H.; Araya, Mario; Perez, Luis A.; Côrtes, Leandro A.; Zukowski, Cleverson N.; Alcantara, Marco; Muniz, Antônio J.; Martinelli, Gustavo C.; de Carvalho Cantarelli, Marcelo J.; Brito, Fábio S.; Baradel, Sandra; de Alencar Araripe Falcão, Breno; Mangione, José A.; Medeiros, César R.; Degrazia, Ramiro C.; Lecaro, José A. N.; Gioppato, Silvio; Ybarra, Luiz F.; Weilenmann, Daniel; Gottschall, Carlos A. M.; Lemke, Viviana; Padilla, Lucio;
• Is Part Of: Catheterization and cardiovascular interventions. Volume 96:Issue 5(2020)
• Page Start: 1046
• Page End: 1055
• Publication Date: 2020-01-28
• Subjects: chronic total occlusion -- coronary artery disease -- percutaneous coronary intervention; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.28744
• Languages: English
• ISSNs: 1522-1946

Abstract

Abstract: Objectives: To report clinical, angiographic characteristics, outcomes, and predictors of unsuccessful procedures in patients who underwent chronic total occlusion (CTO) percutaneous coronary interventions (PCI) in Latin America. Background: CTO PCI has been increasingly performed worldwide, but there is a lack of information in this region. Methods: An international multicenter registry was developed to collect data on CTO PCI performed in centers in Latin America. Patient, angiographic, procedural and outcome data were evaluated. Predictors of unsuccessful procedures were assessed by multivariable analysis. Results: We have included data related to 1, 040 CTO PCIs performed in seven countries in Latin America (Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, and Puerto Rico). The mean age was 64 ± 10 years, and CTO PCI was performed mainly for angina control (81%) or treatment of a large ischemic area (30%). Overall technical success rate was 82.5%, and it was achieved with antegrade wire escalation in 81%, antegrade dissection/re‐entry in 8% and with retrograde techniques in 11% of the successful procedures. Multivariable analysis identified moderate/severe calcification, a blunt proximal cap and a previous attempt as independent predictors of unsuccessful procedures. In‐hospital major adverse cardiovascular events (MACE) occurred in 3.1% of the cases, death in 1% and cardiac tamponade in 0.9% Conclusions: CTO PCI in Latin America has been performed mainly for ischemia relief. Procedures were associated with a success rate above 80% and low incidence of MACE. Predictors of unsuccessful procedures were similar to those previously reported in the literature.