Impact of Calcium on Chronic Total Occlusion Percutaneous Coronary Interventions

The American Journal of Cardiology
Judit KaracsonyiEmmanouil S Brilakis

Abstract

We sought to examine the impact of calcific deposits on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). The outcomes of 1,476 consecutive CTO PCIs performed in 1,453 patients (65.5 ± 10 years, 85% male) between 2012 and 2016 at 11 US centers were evaluated. Moderate or severe quantity of calcium was present in 58% of target lesions. Calcified lesions were more tortuous and more likely to have proximal cap ambiguity and interventional collaterals. PCI of moderately/severely calcified CTOs more often required use of the retrograde approach (54% vs 30%, p <0.001) and was associated with longer procedure and fluoroscopy time and higher air kerma radiation dose and contrast volume. Moderate/severe quantity of calcium was associated with lower technical (86.6% vs 93.8%, p <0.001) and procedural (84.4% vs 92.7%, p <0.001) success rates and higher incidence of major adverse cardiac events (3.7% vs 1.8%, p = 0.033). On multivariate analysis, the presence of moderate/severe quantity of calcium was not independently associated with technical success. Balloon angioplasty was the most common lesion preparation technique for calcified lesions, followed by rotational atherectomy and laser. To conclude, ...Continue Reading

Citations

Apr 30, 2020·Expert Review of Cardiovascular Therapy·Saroj NeupaneKhaldoon Alaswad
Jun 21, 2019·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Lorenzo AzzaliniKambis Mashayekhi
Oct 9, 2019·Expert Review of Medical Devices·Giulia IannacconeRoberto Diletti
Sep 10, 2020·The International Journal of Angiology : Official Publication of the International College of Angiology, Inc·Yudi Her OktavionoDita Aulia Rachmi
Jul 29, 2021·JACC. Case Reports·Judit KaracsonyiEmmanouil S Brilakis
Jul 25, 2021·Revista Española De Cardiología·José R Delgado-AranaIgnacio J Amat-Santos
Sep 9, 2021·Asian Cardiovascular & Thoracic Annals·Jogendra SinghRamachandra Barik

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