Universität zu Köln

Guelker, Jan-Erik, Bufe, Alexander, Blockhaus, Christian, Gesenberg, Jan, Kuervers, Julian, Akin, Ibrahim, Behnes, Michael and Mashayekhi, Kambis (2020). In-Hospital Outcomes After Recanalization of Ostial Chronic Total Occlusions. Cardiovasc. Revascularization Med., 21 (5). S. 661 - 666. SAN DIEGO: ELSEVIER INC. ISSN 1878-0938

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Abstract

Background: Percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) still remains a major challenge in interventional cardiology. Recanalization of ostial lesions is challenging and complex. This present study aims to evaluate the outcome of patients with ostial and non-ostial CTO-PCI with regard to acute, in-hospital outcome. Methods: Between 2012 and 2018 we included 600 patients. Ostial lesions (OL) were defined as a coronary arterial stenosis within 3 mm of the vessel origin. Antegrade and retrograde CTO-PCI techniques were used and a composite safety endpoint comprising in-hospital death, vascular complications, cardiac tamponade, stroke and acute myocardial infarction. Results: The majority of the patients were male (82.3%) and the mean age was 62.1 years (+/- 10.3 years). The right coronary artery (RCA) was the most frequent target vessel in 58.5%, followed by the left circumflex artery (LCX) (15.4%) and the left anterior descending artery (LAD) (26.2%). The success (p = .439) and complication rates (p = .169) were independent of the target vessel. We determined that examination and fluoroscopy time were longer in patients with OL (120.7 min vs. 99.0 min, p < .001 and 44.9 min vs. 34.5 min, p < .001) and that in this group of patients the retrograde approach was used more frequent (38.8% vs. 18.2%, p < .001). Overall success rates were lower in OL than compared to NOL (74.6% vs. 86.5%, p = .016). Conclusions: Our retrospective study suggests that recanalization of ostial CTO lesions is associated with reduced PCI success rates as well as long examination and high fluoroscopy times. (C) 2019 Elsevier Inc. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Guelker, Jan-Erik UNSPECIFIED UNSPECIFIED UNSPECIFIED Bufe, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Blockhaus, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Gesenberg, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuervers, Julian UNSPECIFIED UNSPECIFIED UNSPECIFIED Akin, Ibrahim UNSPECIFIED UNSPECIFIED UNSPECIFIED Behnes, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Mashayekhi, Kambis UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-334668
DOI:	10.1016/j.carrev.2019.09.019
Journal or Publication Title:	Cardiovasc. Revascularization Med.
Volume:	21
Number:	5
Page Range:	S. 661 - 666
Date:	2020
Publisher:	ELSEVIER INC
Place of Publication:	SAN DIEGO
ISSN:	1878-0938
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PERCUTANEOUS CORONARY INTERVENTION; ANTERIOR DESCENDING ARTERY; DRUG-ELUTING STENTS; RADIATION-EXPOSURE; MANAGEMENT STRATEGIES; INSIGHTS; LESIONS; PREDICTORS; REGISTRY; SCORE Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33466