AI Article Synopsis
- - This study compared clinical and angiographic outcomes in patients with coronary chronic total occlusions (CTO) who underwent different recanalisation techniques: dissection and re-entry techniques (DART) and intraplaque techniques.
- - A total of 454 patients were included, with 403 using intraplaque techniques and 70 using DART. Follow-up angiographies and clinical evaluations were conducted over a span of 6 to 12 months.
- - Results showed no significant differences in major adverse cardiac events (MACE) or restenosis rates between the two techniques, indicating that contemporary DART techniques provide similar midterm outcomes to intraplaque techniques.
Article Abstract
Background: Clinical and angiographic outcomes following recanalisation of coronary chronic total occlusions (CTO) through contemporary dissection and re-entry techniques (DART) as opposed to intraplaque techniques remain controversial.
Aims: The aim of this study was to compare clinical and angiographic outcomes following subintimal and intraplaque CTO recanalisation.
Methods: A total of 454 consecutive patients undergoing successful CTO recanalisation (473 vessels) were included. Intraplaque techniques were used in 403 (85.2%) and DART in 70 (14.8%) vessels. Surveillance angiography was scheduled at 6-9 months and clinical follow-up was performed up to 12 months.
Results: There were no significant differences in terms of the cumulative incidence of MACE (p=0.908) or binary restenosis (p=0.320) between the two groups. There was no independent correlation between recanalisation technique and MACE occurrence or in-segment binary restenosis. Target lesion revascularisation (TLR) was performed in 60 (17.5%) and 12 (18.1%) (p=0.719) lesions, respectively. The occurrence of occlusive restenosis was low (7 [2.3%] vs 1 [1.6%]; p=0.824) and comparable between groups.
Conclusions: Contemporary DART are associated with similar midterm clinical and angiographic outcomes compared to intraplaque recanalisation. The rate of occlusive restenosis was low and comparable in both groups. Regardless of recanalisation technique, the overall incidences of binary restenosis and TLR following CTO recanalisation remain higher than those reported for non-CTO PCI.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9724870 | PMC |
| http://dx.doi.org/10.4244/EIJ-D-20-01248 | DOI Listing |
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