scholarly journals A comparison of procedural success rate and long-term clinical outcomes between in-stent restenosis chronic total occlusion and de novo chronic total occlusion using multicenter registry data

2019 ◽  
Vol 109 (5) ◽  
pp. 628-637 ◽  
Author(s):  
Seung Hun Lee ◽  
Jae Young Cho ◽  
Je Sang Kim ◽  
Hyun Jong Lee ◽  
Jeong Hoon Yang ◽  
...  
Keyword(s):  
Success Rate ◽  
Clinical Outcomes ◽  
Chronic Total Occlusion ◽  
De Novo ◽  
Drug Eluting Stent ◽  
Total Occlusion ◽  
Stent Restenosis ◽  
Procedural Success ◽  
In Stent Restenosis

Abstract Background There have been little data about outcomes of percutaneous coronary intervention (PCI) for in-stent restenosis (ISR) chronic total occlusion (CTO) in the drug eluting stent (DES) era. This study aimed to compare the procedural success rate and long-term clinical outcomes of ISR CTO and de novo CTO. Methods and results Patients who underwent PCI for ISR CTO (n = 164) versus de novo CTO (n = 1208) were enrolled from three centers in Korea between January 2008 and December 2014. Among a total of ISR CTO, a proportion of DES ISR CTO was 79.3% (n = 130). The primary outcome was major adverse cardiac events (MACEs); a composite of all-cause death, non-fatal myocardial infarction (MI), or target lesion revascularization (TLR). Following propensity score-matching (1:3), the ISR CTO group (n = 156) had a higher success rate (84.6% vs. 76.0%, p = 0.035), mainly driven by high success rate of PCI for DES ISR CTO (88.6%), but showed a higher incidence of MACEs [hazard ratio (HR): 2.06; 95% confidence interval (CI) 1.37–3.09; p < 0.001], mainly driven by higher prevalence of MI [HR: 9.71; 95% CI 2.06–45.81; p = 0.004] and TLR [HR: 3.04; 95% CI 1.59–5.81; p = 0.001], during 5 years of follow-up after successful revascularization, as compared to the de novo CTO group (n = 408). Conclusion The procedural success rate was higher in the ISR CTO than the de novo CTO, especially in DES ISR CTO. However, irrespective of successful revascularization, the long-term clinical outcomes for the ISR CTO were significantly worse than those for the de novo CTO, in terms of MI and TLR. Graphic abstract

scholarly journals Impact of Chronic Kidney Disease on Chronic Total Occlusion Revascularization Outcomes: A Meta-Analysis

2021 ◽  
Vol 10 (3) ◽  
pp. 440
Author(s):  
Wei-Chieh Lee ◽  
Po-Jui Wu ◽  
Chih-Yuan Fang ◽  
Huang-Chung Chen ◽  
Chiung-Jen Wu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Success Rate ◽  
Clinical Outcomes ◽  
Chronic Total Occlusion ◽  
Systemic Review ◽  
Total Occlusion ◽  
Procedural Success ◽  
Long Term Mortality

Objectives: To examine the impact of revascularization and associated clinical outcomes of chronic kidney disease (CKD) chronic total occlusion (CTO) and non-CKD CTO groups. Background: The influence of CKD on clinical outcomes after percutaneous coronary intervention (PCI) for CTO lesions is unknown, and there is no systemic review of this topic to date. Methods: We searched the PubMed, Embase, ProQuest, ScienceDirect, Cochrane Library, ClinicalKey, Web of Science, and ClinicalTrials Databases for articles published between 1 January 2010 and 31 March 2020. CKD was defined as estimated glomerular filtration rate of <60 mL/min/1.73 m2 according to the Modification of Diet in Renal Disease formula. Data included demographics, lesion distributions, incidence of contrast-induced nephropathy (CIN), acute kidney injury (AKI), procedural success rate, mortality, and target lesion revascularization (TLR)/target vessel revascularization (TVR). Results: Six studies were ultimately included in this systematic review. A high prevalence (25.5%; range, 19.6–37.9%) of CKD was noted in the CTO population. In the non-CKD group, outcomes were better: less incidence of CIN or AKI (odds ratio (OR), 2.860; 95% confidence interval (CI), 1.775–4.608), higher procedural success rate (OR, 1.382; 95% CI, 1.036–1.843), and lower long-term mortality (OR, 4.502; 95% CI, 3.561–5.693). The incidence of TLR/TVR (OR, 1.118; 95% CI, 0.888–1.407) did not differ between groups. Conclusions: In the CKD CTO PCI population, a lower procedural success rate, a higher incidence of CIN or AKI, and higher in-hospital and long-term mortality rate were noted due to more complex lesions and more comorbidities. However, the incidence of TLR/TVR did not differ between groups.

scholarly journals Long term clinical outcomes of brachytherapy, bare-metal stenting, and drug-eluting stenting for de novo and in-stent restenosis lesions: Five year follow-up

2011 ◽  
Vol 18 (6) ◽  
pp. 654-661 ◽  
Author(s):  
Orhan Dogdu ◽  
Mikail Yarlioglues ◽  
Mehmet G. Kaya ◽  
Erol Tulumen ◽  
Bahadir Sarli ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
De Novo ◽  
Bare Metal ◽  
Stent Restenosis ◽  
Drug Eluting ◽  
In Stent Restenosis

Long-Term Outcomes of Drug-Eluting Stent Therapy for In-Stent Restenosis Versus De Novo Lesions

2013 ◽  
Vol 26 (6) ◽  
pp. 550-555 ◽  
Author(s):  
ZHAN GAO ◽  
BO XU ◽  
YUE-JIN YANG ◽  
JIN-QING YUAN ◽  
JUE CHEN ◽  
...  
Keyword(s):  
De Novo ◽  
Drug Eluting Stent ◽  
Long Term Outcomes ◽  
Stent Restenosis ◽  
Drug Eluting ◽  
In Stent Restenosis

scholarly journals TCT-449 Short and Long Term Clinical Outcomes of Chronic Total Occlusion Treatment with a Latest Generation Drug Eluting Stent

2012 ◽  
Vol 60 (17) ◽  
pp. B129
Author(s):  
Alejandro Alcocer Chauvet ◽  
Ralf Blank ◽  
Attila Dirkali ◽  
Sagar Doshi ◽  
Andrejs Erglis ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Chronic Total Occlusion ◽  
Drug Eluting Stent ◽  
Total Occlusion ◽  
Drug Eluting ◽  
Short And Long Term

Comparable 2-Year Restenosis Rates Following Subintimal and Intraluminal Drug-Eluting Stent Implantation for Femoropopliteal Chronic Total Occlusion

2016 ◽  
Vol 23 (6) ◽  
pp. 889-895 ◽  
Author(s):  
Takayuki Ishihara ◽  
Mitsuyoshi Takahara ◽  
Osamu Iida ◽  
Yoshimitsu Soga ◽  
Keisuke Hirano ◽  
...  
Keyword(s):  
Chronic Total Occlusion ◽  
Primary Outcome ◽  
De Novo ◽  
Drug Eluting Stent ◽  
Significant Interaction Effect ◽  
Total Occlusion ◽  
Subintimal Angioplasty ◽  
Drug Eluting ◽  
Baseline Characteristics ◽  
Zilver Ptx

Purpose: To report midterm outcomes after subintimal vs intraluminal drug-eluting stent (DES) implantation for femoropopliteal (FP) chronic total occlusion (CTO). Methods: This subanalysis of the prospective, multicenter ZEPHYR study (ZilvEr PTX for tHe Femoral ArterY and Proximal Popliteal ArteRy) included 176 patients (mean age 74±8 years; 130 men) with 192 de novo FP CTOs that were evaluated by intravascular ultrasound after successful guidewire crossing. The primary outcome was the 2-year restenosis rate after subintimal (n=73) or intraluminal (n=119) DES implantation. Propensity score matching extracted 61 matched pairs (mean age 75 years; 49 men) for patency analysis to minimize baseline intergroup differences. Restenosis rates are reported with the 95% confidence interval (CI). Results: The 1-year restenosis rates in the groups with subintimal and intraluminal DES implantation were 45% (95% CI 32% to 59%) and 35% (95% CI 22% to 49%), respectively (p=0.352), whereas the corresponding rates at 2 years were not significantly different (p=0.648) at 56% (95% CI 41% to 71%) and 51% (95% CI 34% to 68%). Baseline characteristics had no significant interaction effect on the association of subintimal angioplasty with restenosis risk. Conclusion: In FP CTO, 2-year restenosis rates were comparable after subintimal or intraluminal DES implantation.

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