scholarly journals Procedural and follow-up clinical outcomes after chronic total occlusion revascularization: Data from an Indian public hospital

2019 ◽  
Vol 71 (1) ◽  
pp. 65-73
Author(s):  
Ajith Ananthakrishna Pillai ◽  
Sakthivel Ramasamy ◽  
Kabilan S. Jagadheesan ◽  
Santhosh Satheesh ◽  
Raja J. Selvaraj ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Chronic Total Occlusion ◽  
Public Hospital ◽  
Total Occlusion

scholarly journals Evaluation of the Effect of Concurrent Chronic Total Occlusion and Successful Staged Revascularization on Long-Term Mortality in Patients with ST-Elevation Myocardial Infarction

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Guoxiang Shi ◽  
Pengcheng He ◽  
Yuanhui Liu ◽  
Yaowang Lin ◽  
Xing Yang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Clinical Outcomes ◽  
Chronic Total Occlusion ◽  
Early Mortality ◽  
Primary Pci ◽  
Total Occlusion ◽  
The Impact ◽  
Long Term Mortality

Aims. To investigate the impact of chronic total occlusion (CTO) in non-infarct-related artery (IRA) on the long-term prognosis and evaluate the clinical significance of staged revascularization in patients with ST-segment elevation myocardial infarction (STEMI).Methods. 1266 STEMI patients with primary percutaneous coronary intervention (PCI) were categorized as single-vessel disease (SVD), multivessel disease (MVD) without and with CTO. We study the clinical outcomes of patients after primary PCI in the following 3 years. Additionally, patients with CTO received staged revascularization, and major adverse cardiac events (MACE) during 3-year follow-up were recorded.Results. Presence of CTO was a predictor of both early mortality [hazard ratio (HR) 3.4, 95% confidence interval (CI) 2.4–4.5,P<0.01] and late mortality (HR 1.9, 95% CI 1.4–3.6,P<0.01), whereas MVD without CTO was only a predictor of early mortality (HR 1.7, 95% CI 1.3–2.3,P<0.05). In CTO group, 100 patients had successful CTO recanalization, and 48 patients failed. During 3-year follow-up, patients with failed procedure had higher cardiac mortality (22.9% versus 9.0%,P=0.020) and lower MACE-free survival (50.0% versus 72.0%,P=0.009) compared to patients with successful procedure.Conclusion. The presence of CTO and not MVD alone is associated with long-term mortality. Successful revascularization of CTO in the non-IRA is associated with improved clinical outcomes in patients with STEMI undergoing primary PCI.

scholarly journals Long-term follow-up of therapeutic efficacy of everolimus-eluting bioresorbable vascular scaffold in comparison to everolimus-eluting stent in treatment of chronic total occlusion guided by intracoronary imaging

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Mohammad Abdallah Eltahlawi ◽  
Abdel-Aziz Fouad Abdel-Aziz ◽  
Abdel-Salam Sherif ◽  
Khalid Abdel-Azeem Shokry ◽  
Islam Elsayed Shehata
Keyword(s):  
Chronic Total Occlusion ◽  
Bioresorbable Vascular Scaffold ◽  
Total Occlusion ◽  
Intracoronary Imaging ◽  
Group I ◽  
Significant Difference ◽  
Vascular Scaffold ◽  
Long Term Follow Up

Abstract Background We hypothesized that 1st generation everolimus-eluting bioresorbable vascular scaffold (BVS) stent associated with less complication and less restenosis rate than everolimus-eluting stent (EES) in chronic total occlusion (CTO) recanalization guided by intracoronary imaging. Therefore, we aimed to assess the safety and performance of BVS stent in CTO revascularization in comparison to EES guided by intracoronary imaging. Our prospective comparative cross-sectional study was conducted on 60 CTO patients divided into two groups according to type of stent revascularization: group I (EES group): 40 (66.7%) patients and group II (BVS group): 20 (33.3%) patients. All patients were subjected to history taking, electrocardiogram (ECG), echocardiography, laboratory investigation, stress thallium study to assess viability before revascularization. Revascularization of viable CTO lesion guided by intracoronary imaging using optical coherence tomography (OCT). Then, long-term follow-up over 1 year clinically and by multi-slice CT coronary angiography (MSCT). Our clinical and angiographic endpoints were to detect any clinical or angiographic complications during the follow-up period. Results At 6 months angiographic follow-up, BVS group had not inferior angiographic parameters but without statistically significant difference (p = 0.566). At 12 months follow-up, there was no difference at end points between the two groups (p = 0.476). No differences were found at angiographic or clinical follow-up between BVS and EES. Conclusion This study shows that 1st generation everolimus-eluting BVS is non-inferior to EES for CTO revascularization. Further studies are needed to clearly state which new smaller footprint BVS, faster reabsorption, magnesium-based less thrombogenicity, and advanced mechanical properties is under development. We cannot dismiss the efficacy and safety of new BVS technology. Trial registration ZU-IRB#2498/3-12-2016 Registered 3 December 2016, email: [email protected]

scholarly journals CRT-54 Impact Of Multivessel Disease In Patients With Chronic Total Occlusion On Six-month Angiographic And Two-year Clinical Outcomes

2013 ◽  
Vol 6 (2) ◽  
pp. S18
Author(s):  
Seung-Woon Rha ◽  
Byoung Geol Choi ◽  
Se Yeon Choi ◽  
Sung Il Im ◽  
Sun Won Kim ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Chronic Total Occlusion ◽  
Multivessel Disease ◽  
Total Occlusion

scholarly journals Impact of chronic total occlusion lesion length on six-month angiographic and 2-year clinical outcomes

PLoS ONE ◽  
2018 ◽  
Vol 13 (11) ◽  
pp. e0198571 ◽  
Author(s):  
Jihun Ahn ◽  
Seung-Woon Rha ◽  
ByoungGeol Choi ◽  
Se Yeon Choi ◽  
Jae Kyeong Byun ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Chronic Total Occlusion ◽  
Lesion Length ◽  
Total Occlusion

One-year follow-up of myocardial perfusion and function evaluated by gated SPECT MIBI in patients with earlier myocardial infarction and chronic total occlusion

2009 ◽  
Vol 30 (1) ◽  
pp. 68-75 ◽  
Author(s):  
Smiljana V. Pavlovic ◽  
Dragana P. Sobic-Saranovic ◽  
Branko D. Beleslin ◽  
Miodrag C. Ostojic ◽  
Milan A. Nedeljkovic ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Myocardial Perfusion ◽  
Chronic Total Occlusion ◽  
Gated Spect ◽  
Total Occlusion ◽  
One Year ◽  
And Function

124Impact of intimal tracking for recanalization of CTO lesions on long-term clinical outcomes

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Kano ◽  
K Nasu ◽  
M Habara ◽  
T Shimura ◽  
M Yamamoto ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Cox Regression ◽  
Target Lesion ◽  
Hazard Ratio ◽  
Rank Test ◽  
Total Occlusion ◽  
Significant Difference ◽  
The Impact

Abstract Background For recanalization of coronary chronic total occlusion (CTO) lesions, subintimal guidewire tracking in both antegrade and retrograde approaches are commonly used. Purpose This study aimed to assess the impact of subintimal tracking on long-term clinical outcomes after recanalization of CTO lesions. Methods Between January 2009 and December 2016, 474 CTO lesions (434patients) were successfully recanalized in our center. After guidewire crossing in a CTO lesion, those lesions were divided into intimal tracking group (84.6%, n=401) and subintimal tracking group (15.4%, n=73) according to intravascular ultrasound (IVUS) findings. Long-term clinical outcomes including death, target lesion revascularization (TLR), target vessel revascularization (TVR) were compared between the two groups. In addition, the rate of re-occlusion after successful revascularization was also evaluated. Results The median follow-up period was 4.7 years (interquartile range, 2.8–6.1). There was no significant difference of the rate of cardiac death between the two groups (intimal tracking vs. subintimal tracking: 7.0% vs. 4.1%; hazard ratio, 0.61; 95% confidence interval [CI], 0.19 to 2.00; p=0.41), TLR (14.3% vs. 16.2%; hazard ratio, 1.34; 95% CI, 0.71 to 2.53; p=0.37), and TVR (17.5% vs. 20.3%; hazard ratio, 1.27; 95% CI, 0.72 to 2.23; p=0.42). However, the rate of re-occlusion was significantly higher in the subintimal tracking group than intimal tracking group at 3-years re-occlusion (4.2% vs. 14.5%; log-rank test, p=0.002, Figure). In the multivariate COX regression, subintimal guidewire tracking was an independent predictor of re-occlusion after CTO recanalization (HR: 5.40; 95% CI: 2.11–13.80; p<0.001). Figure 1 Conclusions Subintimal guidewire tracking for recanalization of coronary CTO was associated with significantly higher incidence of target lesion re-occlusion during long-term follow-up period.

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