Author + information
- Ananya Kondapalli,
- Haekyung Jeon-Slaughter,
- Ehrin Armstrong,
- Nicolas Shammas,
- Andrew Shammas,
- Anand Prasad,
- Ian Cawich,
- Gerardo Rodriguez,
- Mazen Abu-Fadel,
- Emmanouil Brilakis and
- Subhash Banerjee
Background: Subintimal (SI) and intraluminal (IL) crossing of infrainguinal chronic total occlusion (CTO) lesions is frequently used, however, comparative outcomes are lacking. This study compares postprocedural complications and outcomes between these two techniques.
Methods: We selected 1,335 CTO interventions in 1,001 patients from the multicenter Excellence in Peripheral Artery Disease (XLPAD) registry from January 2005 to October 2015. Outcomes are 30-day and 12-month all-cause mortality, major adverse cardiovascular events, repeat endovascular or surgical revascularization, target limb major amputation, and procedural complications.
Results: SI crossing technique was used in 388 lesions (27%) with lower procedural (p<0.01) and technical (p<0.01) success than the IL technique (Figure 1.A). There was no significant group difference in procedural complications, 30-day and 12-month postprocedural outcomes. 12-month stent thrombosis (ST) was higher in the SI crossing technique (3.0% vs. 1.2%; p=0.04; Figure 1.B). Lesions in the SI group were significantly longer (111.6±24.4 vs. 107.7±24.1, p<0.01) and had a larger reference vessel diameter (4.6±0.3 vs. 4.5±0.4, p<0.01) compared to the IL group.
Conclusions: Subintimal crossing of infrainguinal chronic total occlusion lesions was employed to cross longer lesions. It is associated with similar postprocedural complications and outcomes, albeit with significantly higher stent thrombosis.
Moderated Poster Contributions
Vascular Medicine Moderated Poster Theater, Poster Hall, Hall C
Friday, March 17, 2017, 11:45 a.m.-11:55 a.m.
Session Title: Highlights in Vascular Medicine Research
Abstract Category: 39. Vascular Medicine: Endovascular Therapy
Presentation Number: 1139M-17
- 2017 American College of Cardiology Foundation