Author + information
- Robert Francis Riley,
- Sanjog Kalra,
- Mohamad Lazkani,
- Ashish Pershad,
- Ajay Kirtane,
- William Lombardi,
- Jeffrey Moses,
- James McCabe,
- Tony DeMartini and
- Dimitrios Karmpaliotis
Introduction: Patients with chronic total occlusions (CTO) often have concurrent cardiac disease (left ventricular dysfunction, valvular disease) that increases their procedural risk. We present a multi-center case series describing use of the Impella percutaneous ventricular assist device in this patient group.
Methods: We performed a retrospective analysis of patients at four major medical centers from 2013-2016 and identified patients that underwent hemodynamically supported CTO PCI with the Impella device (2.5 or CP).
Results: We identified 50 patients that underwent CTO PCI with Impella during this period. Average age was 67 years old and 86% were male. 96% had pre-procedural ejection fractions of ≤40%, 28% were identified as having left main or equivalent or last remaining conduit disease, and 22% had severe valvular disease. 34% were performed for acute diagnoses (ACS or decompensated heart failure), 16% utilized atherectomy, 68% had same setting PCI of an addition vessel(s), and 34% utilized the retrograde approach during the procedure. 36% (n=13) used an Impella 2.5 and 74% (n=37) used an Impella CP. 90% of cases were successful with an average of 3.5 stents were deployed per case. 24% of the Impella devices were removed at the end of the procedure. Rates of in-hospital procedural complications are shown in Table I.
Conclusions: Hemodynamically-assisted CTO PCI is a successful method of supporting higher-risk patients through these procedures, though complication rates remain significant.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Advances in Chronic Total Occlusion Intervention
Abstract Category: 20. Interventional Cardiology: Coronary Intervention: CTO
Presentation Number: 1282-123
- 2017 American College of Cardiology Foundation