Author + information
- Shozo Ishihara1,
- Toshiya Muramatsu2,
- Yoshifumi Kashima3,
- Atsunori Okamura4,
- Makoto Mutoh5,
- Masahisa Yamane6,
- Andrzej Brzychczy7,
- Shunsuke Matsuno8,
- satoru otsuji9,
- Ryohei Yoshikawa10 and
- Etsuo Tsuchikane11
- 1Mimihara General Hospital, Osaka, Japan
- 2Saiseikai Yokohama-city Eastern Hospital, Yokohama, Japan
- 3Sapporo Cardio Vascular Clinic, sapporo, Japan
- 4Sakurabashi Watanabe Hospital, Osaka, Japan
- 5Saitama Prefectural Cardiovascular and Respiratory Center, Kumagaya-shi, Japan
- 6Saitama Sekishinkai Hospital, Sayama City, Japan
- 7Department of Vascular Surgery, John Paul II Hospital, Kraków, Poland
- 8Glan Clwyd Hospital
- 9Unknown, Takarazuka, Japan
- 10Thomas Jefferson University Hospital
- 11Toyohashi Heart Center, Toyohashi, Japan
According to previous reports, patients with previously failed or not attempted CTO-PCI had a significantly higher rate of cardiac mortality. We analyzed the Retrograde Summit Registry database to clarify the outcome of re-attempt CTO-PCI.
The data of 3,185 cases were used for the analysis to evaluate efficacy and safety of re-attempt CTO-PCI. The patients were classified into two groups whether the CTO-PCI was attempted followed previous unsuccessful procedure or first attempt.
325 patients received re-attempt PCI (10.2%), of those 102 (31.4%) cases were treated by same operator as previous procedure. Re-attempt group had more complex CTO lesion and procedure success rate was significant low (82.5% vs. 89.1%, P=0004). Moreover, success rate of re-attempt PCI that performed same operator is also significant low (67.7% vs. 89.2%, P=0004). No significant differences were observed in occurrence of MACCE and other complications. Calcified lesion was an independent predictor of procedure failure. The one-year follow up data is in the middle of statistics analysis.
The result indicates the safety of re-attempt CTO-PCI. It is worth to perform re-attempt CTO-PCI for reducing cardiac mortality. However, in that case the preoperative evaluation of lesion calcification and selection of the operator should be considered carefully. The one-year follow up data will be reported at the conference.
CORONARY: Complex and Higher Risk Procedures for Indicated Patients (CHIP)