Universität zu Köln

Guelker, Jan-Erik, Bufe, Alexander, Blockhaus, Christian, Gesenberg, Jan, Kuervers, Julian, Ingerfurth, Klaus, Stein, Johannes and Bansemir, Lars (2019). Acute, in-Hospital Outcome of Percutaneous Coronary Intervention for In-Stent Chronic Total Occlusion. Cardiovasc. Revascularization Med., 20 (11). S. 997 - 1001. SAN DIEGO: ELSEVIER INC. ISSN 1878-0938

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Abstract

Background: Percutaneous coronary intervention (PCI) of total chronic total occlusion (CTO) still remains a major challenge in interventional cardiology. Recanalization of in-stent CTO (IS-CTO) is associated with inferior success rates. This present study aims to comparatively evaluate the acute outcome of patients with IS-CTO and de novo CTO. Methods: Between 2012 and 2018 we included 600 patients. Antegrade and retrograde CTO-PCI techniques were used and the primary endpoint was a composite safety endpoint comprising in-hospital death, vascular complications, cardiac tamponade, stroke and acute myocardial infarction. Results: IS-CTO predominantly occurred in the right coronary artery (71.2%). The success (p = 0.495) and complication rates (p = 0.255) were independent of the target vessel. The lesion lengths of IS-CTO were longer than in de-novo CTO (40 mm vs. 30 mm, statistical trend p = 0.081) alongside with the implanted stent lengths (76 mm vs. 63 mm, statistical trend p = 0.070) and their diameter (3.5 mm vs. 3.0 mm, p < 0.001). We determined that procedural and fluoroscopy time were longer in patients with IS-CTO (115.0 min vs. 93.0 min, p = 0.018 and 40.0 min vs. 30.0 min, p = 0.040) and that in this group of patients the amount of contrast medium was higher (250 ml vs. 200 ml, p = 0.015). Overall success rates were comparable between the two group of patients (87.9% vs. 84.4%, p = 0.586). In-hospital, acute procedural complications regarding the composite safety were rare and showed no statistically significant difference (3.0% vs. 5.6%; p = 0.563). Conclusions: Recanalization of in-stent CTO lesions go along with long procedural and high fluoroscopy times as well as an increased amount of contrast medium. Compared to de novo CTO they can be performed safe in experienced hands with similar success rates. (C) 2018 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 Ingerfurth, Klaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Stein, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Bansemir, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-128398
DOI:	10.1016/j.carrev.2018.12.007
Journal or Publication Title:	Cardiovasc. Revascularization Med.
Volume:	20
Number:	11
Page Range:	S. 997 - 1001
Date:	2019
Publisher:	ELSEVIER INC
Place of Publication:	SAN DIEGO
ISSN:	1878-0938
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CONTRAST-INDUCED NEPHROPATHY; CHRONIC KIDNEY-DISEASE; MANAGEMENT STRATEGIES; TERM OUTCOMES; PATIENTS SKIN; RESTENOSIS; REGISTRY; GUIDELINES; INSIGHTS; LESIONS Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/12839