Grade 3 coronary artery perforations in chronic total occlusion‐percutaneous coronary intervention: Mechanisms, locations, and outcomes from the G3CAP Registry. Issue 2 (10th June 2022)

• Record Type: Journal Article
• Authors: Pavani, Marco; Cerrato, Enrico; Franzè, Alfonso; Colombo, Francesco; Ryan, Nicola; Durante, Alessandro; Bellini, Barbara; Calcagno, Simone; Montorfano, Matteo; Gonzalo, Nieves; Azzalini, Lorenzo; Escaned, Javier; Varbella, Ferdinando
• Is Part Of: Catheterization and cardiovascular interventions. Volume 100:Issue 2(2022)
• Page Start: 190
• Page End: 198
• Publication Date: 2022-06-10
• Subjects: BLEE—bleeding -- CAD—coronary artery disease -- COMI—complications -- PCI -- CTO‐percutaneous coronary intervention -- CTO -- PCI—percutaneous coronary intervention (PCI) -- PCIC—percutaneous coronary intervention -- complex PCI; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.30293
• Languages: English
• ISSNs: 1522-1946

Abstract

Abstract: Aim: The impact of Grade III coronary perforations (G3‐CP) in the setting of CTO‐PCI is not well assessed. Methods and Results: We reviewed 7773 CTO‐PCI and 98, 819 non CTO‐PCI performed in 10 European centers: G3 perforation occurred in 87 patients (1.1%) during CTO PCI and 224 patients (0.22%) during non CTO‐PCI ( p < 0.001). G3‐CP involved the CTO segment in 68% of patients and the retrograde channels in 14% of cases. In the CTO PCI group, wire induced G3‐CP (50.5% vs. 32.5%, p = 0.02) occurred predominantly when dedicated CTO tapered and highly penetrative wires were used. Intra‐procedural and in‐hospital death rates were 4.6% vs. 5.8% and 3.6% vs. 7.5% respectively for CTO PCI and non‐CTO PCI groups ( p = NS). At a median follow up of 24 months, the overall mortality and MAE were respectively 7.8% and MAE 19% without difference among groups. Conclusions: We showed similar in‐hospital and long‐term outcomes when G3 perforations occurred during CTO PCI and non CTO‐PCI.