relation: http://publicatio.bibl.u-szeged.hu/23952/
title: Prevalence and Outcomes of Percutaneous Coronary Interventions for Ostial Chronic Total Occlusions: Insights From a Multicenter Chronic Total Occlusion Registry
creator:  Tajti Péter
creator:  Burke M. Nicholas
creator:  Karmpaliotis Dimitri
creator:  Alaswad Khaldoon
creator:  Jaffer Farouc A.
creator:  Yeh Robert W.
creator:  Patel Mitul
creator:  Mahmud Ehtisham
creator:  Choi James W.
creator:  Doing Anthony H.
creator:  Datilo Phil
creator:  Toma Catalin
creator:  Smith Conrad
creator:  Uretsky Barry
creator:  Ungi Imre
subject: 03.02. Klinikai orvostan
description: Ostial chronic total occlusions (CTOs) can be challenging to recanalize.We sought to examine the prevalence, angiographic presentation, and procedural outcomes of ostial (side-branch ostial and aorto-ostial) CTOs among 1000 CTO percutaneous coronary interventions (PCIs) performed in 971 patients between 2015 and 2017 at 14 centres in the US, Europe, and Russia.Ostial CTOs represented 16.9% of all CTO PCIs: 9.6% were aorto-ostial, and 7.3% were side-branch ostial occlusions. Compared with nonostial CTOs, ostial CTOs were longer (44 ± 33 vs 29 ± 19 mm, P < 0.001) and more likely to have proximal-cap ambiguity (55% vs 33%, P < 0.001), moderate/severe calcification (67% vs 45%, P < 0.001), a diffusely diseased distal vessel (41% vs 26%, P < 0.001), interventional collaterals (64% vs 53%, P = 0.012), and previous coronary artery bypass graft surgery (CABG) (51% vs 27%, P < 0.001). The retrograde approach was used more often in ostial CTOs (54% vs 29%, P < 0.001) and was more often the final successful crossing strategy (30% vs 18%, P = 0.003). Technical (81% vs 84%, P = 0.280), and procedural (77% vs 83%, P = 0.112) success rates and the incidence of in-hospital major complication were similar (4.8% vs 2.2%, P = 0.108), yet in-hospital mortality (3.0% vs 0.5%, P = 0.010) and stroke (1.2% vs 0.0%, P = 0.030) were higher in the ostial CTO PCI group. In multivariable analysis, ostial CTO location was not independently associated with higher risk for in-hospital major complications (adjusted odds ratio 1.27, 95% confidence intervals 0.37 to 4.51, P = 0.694).Ostial CTOs can be recanalized with similar rates of success as nonostial CTOs but are more complex, more likely to require retrograde crossing and may be associated with numerically higher risk for major in-hospital complications.
date: 2018
type: Folyóiratcikk
type: PeerReviewed
format: text
identifier: http://publicatio.bibl.u-szeged.hu/23952/1/Tajti2018.pdf
identifier:     Tajti Péter;  Burke M. Nicholas;  Karmpaliotis Dimitri;  Alaswad Khaldoon;  Jaffer Farouc A.;  Yeh Robert W.;  Patel Mitul;  Mahmud Ehtisham;  Choi James W.;  Doing Anthony H.;  Datilo Phil;  Toma Catalin;  Smith Conrad;  Uretsky Barry;  Ungi Imre: Prevalence and Outcomes of Percutaneous Coronary Interventions for Ostial Chronic Total Occlusions: Insights From a Multicenter Chronic Total Occlusion Registry.   CANADIAN JOURNAL OF CARDIOLOGY, 34 (10).  pp. 1264-1274.  ISSN 0828-282X (2018)     
identifier: doi:10.1016/j.cjca.2018.07.472
relation: http://doi.org/10.1016/j.cjca.2018.07.472
relation: 30420610
language: eng
relation: info:eu-repo/semantics/altIdentifier/doi/10.1016/j.cjca.2018.07.472
rights: info:eu-repo/semantics/openAccess