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Use of Intravascular Imaging During Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Contemporary Multicenter Registry
BACKGROUND: Intravascular imaging can facilitate chronic total occlusion (CTO) percutaneous coronary intervention. METHODS AND RESULTS: We examined the frequency of use and outcomes of intravascular imaging among 619 CTO percutaneous coronary interventions performed between 2012 and 2015 at 7 US cen...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015304/ https://www.ncbi.nlm.nih.gov/pubmed/27543800 http://dx.doi.org/10.1161/JAHA.116.003890 |
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author | Karacsonyi, Judit Alaswad, Khaldoon Jaffer, Farouc A. Yeh, Robert W. Patel, Mitul Bahadorani, John Karatasakis, Aris Danek, Barbara A. Doing, Anthony Grantham, J. Aaron Karmpaliotis, Dimitri Moses, Jeffrey W. Kirtane, Ajay Parikh, Manish Ali, Ziad Lombardi, William L. Kandzari, David E. Lembo, Nicholas Garcia, Santiago Wyman, Michael R. Alame, Aya Nguyen‐Trong, Phuong‐Khanh J. Resendes, Erica Kalsaria, Pratik Rangan, Bavana V. Ungi, Imre Thompson, Craig A. Banerjee, Subhash Brilakis, Emmanouil S. |
author_facet | Karacsonyi, Judit Alaswad, Khaldoon Jaffer, Farouc A. Yeh, Robert W. Patel, Mitul Bahadorani, John Karatasakis, Aris Danek, Barbara A. Doing, Anthony Grantham, J. Aaron Karmpaliotis, Dimitri Moses, Jeffrey W. Kirtane, Ajay Parikh, Manish Ali, Ziad Lombardi, William L. Kandzari, David E. Lembo, Nicholas Garcia, Santiago Wyman, Michael R. Alame, Aya Nguyen‐Trong, Phuong‐Khanh J. Resendes, Erica Kalsaria, Pratik Rangan, Bavana V. Ungi, Imre Thompson, Craig A. Banerjee, Subhash Brilakis, Emmanouil S. |
author_sort | Karacsonyi, Judit |
collection | PubMed |
description | BACKGROUND: Intravascular imaging can facilitate chronic total occlusion (CTO) percutaneous coronary intervention. METHODS AND RESULTS: We examined the frequency of use and outcomes of intravascular imaging among 619 CTO percutaneous coronary interventions performed between 2012 and 2015 at 7 US centers. Mean age was 65.4±10 years and 85% of the patients were men. Intravascular imaging was used in 38%: intravascular ultrasound in 36%, optical coherence tomography in 3%, and both in 1.45%. Intravascular imaging was used for stent sizing (26.3%), stent optimization (38.0%), and CTO crossing (35.7%, antegrade in 27.9%, and retrograde in 7.8%). Intravascular imaging to facilitate crossing was used more frequently in lesions with proximal cap ambiguity (49% versus 26%, P<0.0001) and with retrograde as compared with antegrade‐only cases (67% versus 31%, P<0.0001). Despite higher complexity (Japanese CTO score: 2.86±1.19 versus 2.43±1.19, P=0.001), cases in which imaging was used for crossing had similar technical and procedural success (92.8% versus 89.6%, P=0.302 and 90.1% versus 88.3%, P=0.588, respectively) and similar incidence of major cardiac adverse events (2.7% versus 3.2%, P=0.772). Use of intravascular imaging was associated with longer procedure (192 minutes [interquartile range 130, 255] versus 131 minutes [90, 192], P<0.0001) and fluoroscopy (71 minutes [44, 93] versus 39 minutes [25, 69], P<0.0001) time. CONCLUSIONS: Intravascular imaging is frequently performed during CTO percutaneous coronary intervention both for crossing and for stent selection/optimization. Despite its use in more complex lesion subsets, intravascular imaging was associated with similar rates of technical and procedural success for CTO percutaneous coronary intervention. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02061436. |
format | Online Article Text |
id | pubmed-5015304 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-50153042016-09-19 Use of Intravascular Imaging During Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Contemporary Multicenter Registry Karacsonyi, Judit Alaswad, Khaldoon Jaffer, Farouc A. Yeh, Robert W. Patel, Mitul Bahadorani, John Karatasakis, Aris Danek, Barbara A. Doing, Anthony Grantham, J. Aaron Karmpaliotis, Dimitri Moses, Jeffrey W. Kirtane, Ajay Parikh, Manish Ali, Ziad Lombardi, William L. Kandzari, David E. Lembo, Nicholas Garcia, Santiago Wyman, Michael R. Alame, Aya Nguyen‐Trong, Phuong‐Khanh J. Resendes, Erica Kalsaria, Pratik Rangan, Bavana V. Ungi, Imre Thompson, Craig A. Banerjee, Subhash Brilakis, Emmanouil S. J Am Heart Assoc Original Research BACKGROUND: Intravascular imaging can facilitate chronic total occlusion (CTO) percutaneous coronary intervention. METHODS AND RESULTS: We examined the frequency of use and outcomes of intravascular imaging among 619 CTO percutaneous coronary interventions performed between 2012 and 2015 at 7 US centers. Mean age was 65.4±10 years and 85% of the patients were men. Intravascular imaging was used in 38%: intravascular ultrasound in 36%, optical coherence tomography in 3%, and both in 1.45%. Intravascular imaging was used for stent sizing (26.3%), stent optimization (38.0%), and CTO crossing (35.7%, antegrade in 27.9%, and retrograde in 7.8%). Intravascular imaging to facilitate crossing was used more frequently in lesions with proximal cap ambiguity (49% versus 26%, P<0.0001) and with retrograde as compared with antegrade‐only cases (67% versus 31%, P<0.0001). Despite higher complexity (Japanese CTO score: 2.86±1.19 versus 2.43±1.19, P=0.001), cases in which imaging was used for crossing had similar technical and procedural success (92.8% versus 89.6%, P=0.302 and 90.1% versus 88.3%, P=0.588, respectively) and similar incidence of major cardiac adverse events (2.7% versus 3.2%, P=0.772). Use of intravascular imaging was associated with longer procedure (192 minutes [interquartile range 130, 255] versus 131 minutes [90, 192], P<0.0001) and fluoroscopy (71 minutes [44, 93] versus 39 minutes [25, 69], P<0.0001) time. CONCLUSIONS: Intravascular imaging is frequently performed during CTO percutaneous coronary intervention both for crossing and for stent selection/optimization. Despite its use in more complex lesion subsets, intravascular imaging was associated with similar rates of technical and procedural success for CTO percutaneous coronary intervention. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02061436. John Wiley and Sons Inc. 2016-08-20 /pmc/articles/PMC5015304/ /pubmed/27543800 http://dx.doi.org/10.1161/JAHA.116.003890 Text en © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Karacsonyi, Judit Alaswad, Khaldoon Jaffer, Farouc A. Yeh, Robert W. Patel, Mitul Bahadorani, John Karatasakis, Aris Danek, Barbara A. Doing, Anthony Grantham, J. Aaron Karmpaliotis, Dimitri Moses, Jeffrey W. Kirtane, Ajay Parikh, Manish Ali, Ziad Lombardi, William L. Kandzari, David E. Lembo, Nicholas Garcia, Santiago Wyman, Michael R. Alame, Aya Nguyen‐Trong, Phuong‐Khanh J. Resendes, Erica Kalsaria, Pratik Rangan, Bavana V. Ungi, Imre Thompson, Craig A. Banerjee, Subhash Brilakis, Emmanouil S. Use of Intravascular Imaging During Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Contemporary Multicenter Registry |
title | Use of Intravascular Imaging During Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Contemporary Multicenter Registry |
title_full | Use of Intravascular Imaging During Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Contemporary Multicenter Registry |
title_fullStr | Use of Intravascular Imaging During Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Contemporary Multicenter Registry |
title_full_unstemmed | Use of Intravascular Imaging During Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Contemporary Multicenter Registry |
title_short | Use of Intravascular Imaging During Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Contemporary Multicenter Registry |
title_sort | use of intravascular imaging during chronic total occlusion percutaneous coronary intervention: insights from a contemporary multicenter registry |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015304/ https://www.ncbi.nlm.nih.gov/pubmed/27543800 http://dx.doi.org/10.1161/JAHA.116.003890 |
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