AI Article Synopsis

  • The study looked at the outcomes of patients undergoing percutaneous coronary intervention (PCI) for left main (LM) chronic total occlusions (CTO) compared to non-LM CTOs across multiple centers from 2012 to 2024.
  • Out of over 15,000 CTO PCIs, only 85 involved LM CTOs, which were associated with older patients who commonly had higher rates of health issues like heart failure and previous bypass surgeries.
  • Despite higher complications and angiographic complexity in LM CTO cases, the technical success rates were similar to non-LM PCIs, indicating that they can be performed safely despite their challenges.

Article Abstract

Background: Percutaneous coronary intervention (PCI) of left main (LM) chronic total occlusions (CTO) has received limited study.

Methods: We compared the clinical and procedural characteristics and outcomes of patients who underwent LM versus non-LM CTO PCI at 41 US and non-US centers between 2012 and 2024.

Results: During the study period 85 of 15,254 CTO PCIs (0.6%) performed in 14,969 patients were LM CTO PCIs. LM CTO PCI patients were older, had higher rates of dyslipidemia and heart failure and most (88.8%) had prior coronary artery bypass graft surgery (CABG). They were more likely to have moderately or severely calcified lesions (80.7% vs. 45.7%, p < 0.001) and had higher J-CTO (2.76 ± 1.17 vs. 2.37 ± 1.26, p = 0.008), PROGRESS-CTO MACE (3.56 vs. 2.57, p < 0.001), Mortality (2.45 vs. 1.68, p < 0.001), Pericardiocentesis (2.74 vs. 1.87, p < 0.001), Acute MI (1.72 vs. 0.89, p < 0.001) and Perforation (3.21 vs. 2.19, p < 0.001) scores. There was no difference in technical success (80.5% vs. 87.2%, p = 0.086) or major cardiovascular adverse events (MACE) (2.4% vs. 2.0%, p = 0.700). LM CTO PCI patients with and without prior CABG surgery had similar technical success and MACE. The retrograde approach in prior CABG patients was more likely to be performed through saphenous vein grafts.

Conclusions: LM CTO PCI is infrequently performed, is associated with high comorbidity burden and angiographic complexity but can be performed with high success and acceptable complication rates.

Download full-text PDF

Source
http://dx.doi.org/10.1002/ccd.31289DOI Listing

Publication Analysis

Top Keywords

left main
8
main chronic
8
chronic total
8
percutaneous coronary
8
cto pci
8
cto pcis
8
cto
5
outcomes left
4
total occlusion
4
occlusion percutaneous
4

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!