Procedural Results and Long-term Outcome of Chronic Total Occlusion Percutaneous Coronary Intervention in a UK Non-surgical Centre
Background: Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has evolved a great deal over recent years, with increased procedural success and lower complication rates being reported. This study aims to evaluate the feasibility, safety and success of a dedicated CTO programme i...
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Radcliffe Medical Media
2024-05-01
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| Series: | Interventional Cardiology: Reviews, Research, Resources |
| Online Access: | https://www.icrjournal.com/articleindex/icr.2023.23 |
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| author | Thomas R Gilpin Annette Maznyczka Brijesh Anantharam Ali Dana |
| author_facet | Thomas R Gilpin Annette Maznyczka Brijesh Anantharam Ali Dana |
| author_sort | Thomas R Gilpin |
| collection | DOAJ |
| description | Background: Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has evolved a great deal over recent years, with increased procedural success and lower complication rates being reported. This study aims to evaluate the feasibility, safety and success of a dedicated CTO programme in a large UK PCI centre without on-site cardiothoracic surgery facilities. Methods: Clinical and procedural data were retrospectively collected for consecutive unselected patients undergoing CTO PCI between 2015 and 2019 from the local database and regional electronic patient records. In-hospital outcomes and long-term major adverse cardiovascular events (all-cause mortality, MI, stroke and target vessel revascularisation) were recorded. Results: A total of 170 patients underwent 191 CTO procedures during the study period. The mean age was 63 ± 10 years and 80.6% of patients were male (n=137). The clinical indications were: stable chronic coronary syndromes in 88.5% (n=169) of patients; staged procedures in the context of acute coronary syndromes in 1.6% (n=3); and presentation with acute coronary syndrome in 9.9% (n=19). The procedural success rate was 50.0% (n=25) for general interventional cardiologists and 90.1% (n=127) for dedicated CTO operators. In-hospital major adverse cardiovascular events occurred once (0.5%) and interhospital transfer for emergency salvage cardiac surgery was not required. Long-term follow-up data at a median duration of 3.8 years revealed 4 (2.4%) cardiac deaths, 14 (8.3%) spontaneous MI events and 10 (5.9%) target vessel revascularisations. Conclusion: These data suggest CTO PCI using contemporary techniques is both safe and effective when undertaken in a high-volume non-surgical centre by experienced operators. |
| format | Article |
| id | doaj-art-df9d85487fca4f08b563a1eaaf61208a |
| institution | DOAJ |
| issn | 1756-1477 1756-1485 |
| language | English |
| publishDate | 2024-05-01 |
| publisher | Radcliffe Medical Media |
| record_format | Article |
| series | Interventional Cardiology: Reviews, Research, Resources |
| spelling | doaj-art-df9d85487fca4f08b563a1eaaf61208a2025-08-20T02:39:23ZengRadcliffe Medical MediaInterventional Cardiology: Reviews, Research, Resources1756-14771756-14852024-05-011910.15420/icr.2023.23Procedural Results and Long-term Outcome of Chronic Total Occlusion Percutaneous Coronary Intervention in a UK Non-surgical CentreThomas R Gilpin0Annette Maznyczka1Brijesh Anantharam2Ali Dana3Faculty of Medicine, University of Southampton, Southampton, UK; Portsmouth Hospitals University NHS Trust, Queen Alexandra Hospital, Portsmouth, UKPortsmouth Hospitals University NHS Trust, Queen Alexandra Hospital, Portsmouth, UKPortsmouth Hospitals University NHS Trust, Queen Alexandra Hospital, Portsmouth, UKPortsmouth Hospitals University NHS Trust, Queen Alexandra Hospital, Portsmouth, UKBackground: Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has evolved a great deal over recent years, with increased procedural success and lower complication rates being reported. This study aims to evaluate the feasibility, safety and success of a dedicated CTO programme in a large UK PCI centre without on-site cardiothoracic surgery facilities. Methods: Clinical and procedural data were retrospectively collected for consecutive unselected patients undergoing CTO PCI between 2015 and 2019 from the local database and regional electronic patient records. In-hospital outcomes and long-term major adverse cardiovascular events (all-cause mortality, MI, stroke and target vessel revascularisation) were recorded. Results: A total of 170 patients underwent 191 CTO procedures during the study period. The mean age was 63 ± 10 years and 80.6% of patients were male (n=137). The clinical indications were: stable chronic coronary syndromes in 88.5% (n=169) of patients; staged procedures in the context of acute coronary syndromes in 1.6% (n=3); and presentation with acute coronary syndrome in 9.9% (n=19). The procedural success rate was 50.0% (n=25) for general interventional cardiologists and 90.1% (n=127) for dedicated CTO operators. In-hospital major adverse cardiovascular events occurred once (0.5%) and interhospital transfer for emergency salvage cardiac surgery was not required. Long-term follow-up data at a median duration of 3.8 years revealed 4 (2.4%) cardiac deaths, 14 (8.3%) spontaneous MI events and 10 (5.9%) target vessel revascularisations. Conclusion: These data suggest CTO PCI using contemporary techniques is both safe and effective when undertaken in a high-volume non-surgical centre by experienced operators.https://www.icrjournal.com/articleindex/icr.2023.23 |
| spellingShingle | Thomas R Gilpin Annette Maznyczka Brijesh Anantharam Ali Dana Procedural Results and Long-term Outcome of Chronic Total Occlusion Percutaneous Coronary Intervention in a UK Non-surgical Centre Interventional Cardiology: Reviews, Research, Resources |
| title | Procedural Results and Long-term Outcome of Chronic Total Occlusion Percutaneous Coronary Intervention in a UK Non-surgical Centre |
| title_full | Procedural Results and Long-term Outcome of Chronic Total Occlusion Percutaneous Coronary Intervention in a UK Non-surgical Centre |
| title_fullStr | Procedural Results and Long-term Outcome of Chronic Total Occlusion Percutaneous Coronary Intervention in a UK Non-surgical Centre |
| title_full_unstemmed | Procedural Results and Long-term Outcome of Chronic Total Occlusion Percutaneous Coronary Intervention in a UK Non-surgical Centre |
| title_short | Procedural Results and Long-term Outcome of Chronic Total Occlusion Percutaneous Coronary Intervention in a UK Non-surgical Centre |
| title_sort | procedural results and long term outcome of chronic total occlusion percutaneous coronary intervention in a uk non surgical centre |
| url | https://www.icrjournal.com/articleindex/icr.2023.23 |
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