Effect of Previous Failure on Subsequent Procedural Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention (from a Contemporary Multicenter Registry)

Judit Karacsonyi; Aris Karatasakis; Dimitri Karmpaliotis; Khaldoon Alaswad; Robert W. Yeh; Farouc A. Jaffer; Michael R. Wyman; William L. Lombardi; J. Aaron Grantham; David E. Kandzari; Nicholas Lembo; Jeffrey W. Moses; Ajay J. Kirtane; Manish A. Parikh; Philip Green; Matthew Finn; Santiago Garcia; Anthony Doing; Mitul Patel; John Bahadorani; Jose Roberto Martinez Parachini; Erica Resendes; Bavana V. Rangan; Imre Ungi; Craig A. Thompson; Subhash Banerjee; Emmanouil S. Brilakis

doi:10.1016/j.amjcard.2016.01.021

Effect of Previous Failure on Subsequent Procedural Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention (from a Contemporary Multicenter Registry)

Judit Karacsonyi, Aris Karatasakis, Dimitri Karmpaliotis, Khaldoon Alaswad, Robert W. Yeh, Farouc A. Jaffer, Michael R. Wyman, William L. Lombardi, J. Aaron Grantham, David E. Kandzari, Nicholas Lembo, Jeffrey W. Moses, Ajay J. Kirtane, Manish A. Parikh, Philip Green, Matthew Finn, Santiago Garcia, Anthony Doing, Mitul Patel, John BahadoraniJose Roberto Martinez Parachini, Erica Resendes, Bavana V. Rangan, Imre Ungi, Craig A. Thompson, Subhash Banerjee, Emmanouil S. Brilakis

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Abstract

We sought to examine the impact of previous failure on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We examined the clinical and angiographic characteristics and procedural outcomes of 1,213 consecutive patients who underwent 1,232 CTO PCIs from 2012 to 2015 at 12 US centers. Mean age was 65 ± 10 years, and 84.8% of patients were men. A previously failed attempt had been performed in 215 patients (17.5%). As compared with patients without previous CTO PCI failure, patients with previous failure had higher Multicenter CTO Registry in Japan CTO score (2.40 ± 1.13 vs 3.28 ± 1.29, p <0.0001) and were more likely to have in-stent restenosis (10.5% vs 28.4%, p <0.0001) and to undergo recanalization attempts using the retrograde approach (41% vs 50%, p = 0.011). Technical (90% vs 88%, p = 0.390) and procedural (89% vs 86%, p = 0.184) success were similar in the 2 study groups; however, median procedure time (125 vs 142 minutes, p = 0.026) and fluoroscopy time (45 vs 55 minutes, p = 0.015) were longer in the previous failure group. In conclusion, a previously failed CTO PCI attempt is associated with higher angiographic complexity, longer procedural duration, and fluoroscopy time, but not with the success and complication rates of subsequent CTO PCI attempts.

Original language	English (US)
Pages (from-to)	1267-1271
Number of pages	5
Journal	American Journal of Cardiology
Volume	117
Issue number	8
DOIs	https://doi.org/10.1016/j.amjcard.2016.01.021
State	Published - Apr 15 2016
Externally published	Yes

Bibliographical note

Funding Information:
Supported by CTSA NIH Grant UL1-RR024982. Dr. Karmpaliotis is on the speaker''s bureau of Abbott Vascular, Medtronic, and Boston Scientific. Dr. Alaswad receives consulting fees from Terumo and Boston Scientific and is a consultant, no financial, Abbott Laboratories. Dr. Yeh receives Career Development Award (1K23HL118138) from the National Heart, Lung, and Blood Institute. Dr. Jaffer is a consultant to Boston Scientific, Siemens, and Merck, and receives nonfinancial research support from Abbott Vascular, research grant HL-R01-108229 from National Institutes of Health. Dr. Wyman receives honoraria/consulting/speaking fees from Boston Scientific, Abbott Vascular, and Asahi. Dr. Lombardi: equity with Bridgepoint Medical. Dr. Grantham receives speaking fees, consulting, and honoraria from Boston Scientific, Asahi Intecc. He also receives research grants from Boston Scientific, Asahi Intecc, Abbott Vascular, and Medtronic. Dr. Kandzari receives research/grant support and consulting honoraria from Boston Scientific and Medtronic Cardiovascular, and research/grant support from Abbott. Dr. Lembo is on the speaker''s bureau of Medtronic; advisory board Abbott Vascular and Medtronic. Dr. Kirtane receives institutional research grants to Columbia University from Boston Scientific, Medtronic, Abbott Vascular, Abiomed, St. Jude Medical, Vascular Dynamics, Glaxo SmithKline, and Eli Lilly. Dr. Garcia receives consulting fees from Medtronic. Dr. Thompson is an employee of Boston Scientific. Dr. Banerjee receives research grants from Gilead and the Medicines Company; consultant/speaker honoraria from Covidien and Medtronic; ownership in MDCARE Global (spouse); intellectual property in HygeiaTel. Dr. Brilakis receives consulting/speaker honoraria from Abbott Vascular, Asahi, Boston Scientific, Elsevier, Somahlution, St Jude Medical, and Terumo; research support from Boston Scientific and InfraRedx; spouse is employee of Medtronic. The other authors have no conflicts of interest to disclose.

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Karacsonyi, J., Karatasakis, A., Karmpaliotis, D., Alaswad, K., Yeh, R. W., Jaffer, F. A., Wyman, M. R., Lombardi, W. L., Grantham, J. A., Kandzari, D. E., Lembo, N., Moses, J. W., Kirtane, A. J., Parikh, M. A., Green, P., Finn, M., Garcia, S., Doing, A., Patel, M., ... Brilakis, E. S. (2016). Effect of Previous Failure on Subsequent Procedural Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention (from a Contemporary Multicenter Registry). American Journal of Cardiology, 117(8), 1267-1271. https://doi.org/10.1016/j.amjcard.2016.01.021

Effect of Previous Failure on Subsequent Procedural Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention (from a Contemporary Multicenter Registry). / Karacsonyi, Judit; Karatasakis, Aris; Karmpaliotis, Dimitri et al.
In: American Journal of Cardiology, Vol. 117, No. 8, 15.04.2016, p. 1267-1271.

Research output: Contribution to journal › Article › peer-review

Karacsonyi, J, Karatasakis, A, Karmpaliotis, D, Alaswad, K, Yeh, RW, Jaffer, FA, Wyman, MR, Lombardi, WL, Grantham, JA, Kandzari, DE, Lembo, N, Moses, JW, Kirtane, AJ, Parikh, MA, Green, P, Finn, M, Garcia, S, Doing, A, Patel, M, Bahadorani, J, Martinez Parachini, JR, Resendes, E, Rangan, BV, Ungi, I, Thompson, CA, Banerjee, S & Brilakis, ES 2016, 'Effect of Previous Failure on Subsequent Procedural Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention (from a Contemporary Multicenter Registry)', American Journal of Cardiology, vol. 117, no. 8, pp. 1267-1271. https://doi.org/10.1016/j.amjcard.2016.01.021

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title = "Effect of Previous Failure on Subsequent Procedural Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention (from a Contemporary Multicenter Registry)",

abstract = "We sought to examine the impact of previous failure on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We examined the clinical and angiographic characteristics and procedural outcomes of 1,213 consecutive patients who underwent 1,232 CTO PCIs from 2012 to 2015 at 12 US centers. Mean age was 65 ± 10 years, and 84.8% of patients were men. A previously failed attempt had been performed in 215 patients (17.5%). As compared with patients without previous CTO PCI failure, patients with previous failure had higher Multicenter CTO Registry in Japan CTO score (2.40 ± 1.13 vs 3.28 ± 1.29, p <0.0001) and were more likely to have in-stent restenosis (10.5% vs 28.4%, p <0.0001) and to undergo recanalization attempts using the retrograde approach (41% vs 50%, p = 0.011). Technical (90% vs 88%, p = 0.390) and procedural (89% vs 86%, p = 0.184) success were similar in the 2 study groups; however, median procedure time (125 vs 142 minutes, p = 0.026) and fluoroscopy time (45 vs 55 minutes, p = 0.015) were longer in the previous failure group. In conclusion, a previously failed CTO PCI attempt is associated with higher angiographic complexity, longer procedural duration, and fluoroscopy time, but not with the success and complication rates of subsequent CTO PCI attempts.",

author = "Judit Karacsonyi and Aris Karatasakis and Dimitri Karmpaliotis and Khaldoon Alaswad and Yeh, {Robert W.} and Jaffer, {Farouc A.} and Wyman, {Michael R.} and Lombardi, {William L.} and Grantham, {J. Aaron} and Kandzari, {David E.} and Nicholas Lembo and Moses, {Jeffrey W.} and Kirtane, {Ajay J.} and Parikh, {Manish A.} and Philip Green and Matthew Finn and Santiago Garcia and Anthony Doing and Mitul Patel and John Bahadorani and {Martinez Parachini}, {Jose Roberto} and Erica Resendes and Rangan, {Bavana V.} and Imre Ungi and Thompson, {Craig A.} and Subhash Banerjee and Brilakis, {Emmanouil S.}",

note = "Funding Information: Supported by CTSA NIH Grant UL1-RR024982. Dr. Karmpaliotis is on the speaker''s bureau of Abbott Vascular, Medtronic, and Boston Scientific. Dr. Alaswad receives consulting fees from Terumo and Boston Scientific and is a consultant, no financial, Abbott Laboratories. Dr. Yeh receives Career Development Award (1K23HL118138) from the National Heart, Lung, and Blood Institute. Dr. Jaffer is a consultant to Boston Scientific, Siemens, and Merck, and receives nonfinancial research support from Abbott Vascular, research grant HL-R01-108229 from National Institutes of Health. Dr. Wyman receives honoraria/consulting/speaking fees from Boston Scientific, Abbott Vascular, and Asahi. Dr. Lombardi: equity with Bridgepoint Medical. Dr. Grantham receives speaking fees, consulting, and honoraria from Boston Scientific, Asahi Intecc. He also receives research grants from Boston Scientific, Asahi Intecc, Abbott Vascular, and Medtronic. Dr. Kandzari receives research/grant support and consulting honoraria from Boston Scientific and Medtronic Cardiovascular, and research/grant support from Abbott. Dr. Lembo is on the speaker''s bureau of Medtronic; advisory board Abbott Vascular and Medtronic. Dr. Kirtane receives institutional research grants to Columbia University from Boston Scientific, Medtronic, Abbott Vascular, Abiomed, St. Jude Medical, Vascular Dynamics, Glaxo SmithKline, and Eli Lilly. Dr. Garcia receives consulting fees from Medtronic. Dr. Thompson is an employee of Boston Scientific. Dr. Banerjee receives research grants from Gilead and the Medicines Company; consultant/speaker honoraria from Covidien and Medtronic; ownership in MDCARE Global (spouse); intellectual property in HygeiaTel. Dr. Brilakis receives consulting/speaker honoraria from Abbott Vascular, Asahi, Boston Scientific, Elsevier, Somahlution, St Jude Medical, and Terumo; research support from Boston Scientific and InfraRedx; spouse is employee of Medtronic. The other authors have no conflicts of interest to disclose.",

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AU - Alaswad, Khaldoon

AU - Yeh, Robert W.

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AU - Thompson, Craig A.

AU - Banerjee, Subhash

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N2 - We sought to examine the impact of previous failure on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We examined the clinical and angiographic characteristics and procedural outcomes of 1,213 consecutive patients who underwent 1,232 CTO PCIs from 2012 to 2015 at 12 US centers. Mean age was 65 ± 10 years, and 84.8% of patients were men. A previously failed attempt had been performed in 215 patients (17.5%). As compared with patients without previous CTO PCI failure, patients with previous failure had higher Multicenter CTO Registry in Japan CTO score (2.40 ± 1.13 vs 3.28 ± 1.29, p <0.0001) and were more likely to have in-stent restenosis (10.5% vs 28.4%, p <0.0001) and to undergo recanalization attempts using the retrograde approach (41% vs 50%, p = 0.011). Technical (90% vs 88%, p = 0.390) and procedural (89% vs 86%, p = 0.184) success were similar in the 2 study groups; however, median procedure time (125 vs 142 minutes, p = 0.026) and fluoroscopy time (45 vs 55 minutes, p = 0.015) were longer in the previous failure group. In conclusion, a previously failed CTO PCI attempt is associated with higher angiographic complexity, longer procedural duration, and fluoroscopy time, but not with the success and complication rates of subsequent CTO PCI attempts.

AB - We sought to examine the impact of previous failure on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We examined the clinical and angiographic characteristics and procedural outcomes of 1,213 consecutive patients who underwent 1,232 CTO PCIs from 2012 to 2015 at 12 US centers. Mean age was 65 ± 10 years, and 84.8% of patients were men. A previously failed attempt had been performed in 215 patients (17.5%). As compared with patients without previous CTO PCI failure, patients with previous failure had higher Multicenter CTO Registry in Japan CTO score (2.40 ± 1.13 vs 3.28 ± 1.29, p <0.0001) and were more likely to have in-stent restenosis (10.5% vs 28.4%, p <0.0001) and to undergo recanalization attempts using the retrograde approach (41% vs 50%, p = 0.011). Technical (90% vs 88%, p = 0.390) and procedural (89% vs 86%, p = 0.184) success were similar in the 2 study groups; however, median procedure time (125 vs 142 minutes, p = 0.026) and fluoroscopy time (45 vs 55 minutes, p = 0.015) were longer in the previous failure group. In conclusion, a previously failed CTO PCI attempt is associated with higher angiographic complexity, longer procedural duration, and fluoroscopy time, but not with the success and complication rates of subsequent CTO PCI attempts.

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Effect of Previous Failure on Subsequent Procedural Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention (from a Contemporary Multicenter Registry)

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