Edorium Journal of

Cardiology

 
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Original Article
 
Short-term and long-term outlook after eventually successful albeit transiently complicated percutaneous coronary intervention for chronic total occlusion: The Rivoli chronic total occlusion registry
Andrea Gagnor1, Ferdinando Varbella1, Francesco Tomassini1, Sara Giolitto1, Cristina Rolfo1, Emanuele Tizzani1, Enrico Cerrato1, Alfonso Gambino1, Elisa Favro1, Rosario Tripodi1, Maria Cristina Rosa Brusin1, Paolo Gyai Pron1, Mariangela Peruzzi2, Giuseppe Biondi-Zoccai2,3
1MD, Division of Cardiology, Rivoli Hospital, Rivoli, Italy.
2MD, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.
3MD, Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy (GBZ).

Article ID: 100007C03AG2016
doi:10.5348/C03-2016-7-OA-3

Address correspondence to:
Giuseppe Biondi-Zoccai
MD, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome
Corso della Repubblica 79
04100 Latina
Italy

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How to cite this article
Gagnor A, Varbella F, Tomassini F, giolitto S, Rolfo C, Tizzani E, Cerrato E, Gambino A, Favro E, Tripodi R, Brusin MCR, Pron PG, Peruzzi M, Biondi-Zoccai G. Short-term and long-term outlook after eventually successful albeit transiently complicated percutaneous coronary intervention for chronic total occlusion: The Rivoli chronic total occlusion registry. Edorium J Cardiol 2016;3:13–21.


Abstract
Aims: We aimed to appraise the outlook of successful albeit transiently complicated percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). Percutaneous coronary intervention of CTO may improve symptoms, systolic function and prognosis, but may be associated with short-term complications.
Methods: Baseline, procedural and outcome details on patients in whom CTO PCI was attempted between 2003 and 2012 at our institution were retrieved. We compared those with failed PCI (F group) to those with successful and uncomplicated PCI (SU group) and those with eventually successful albeit transiently complicated PCI (SC group).
Results: A total of 435 patients were included, with 25.7% failures and 74.3% successes, including 67.8% in the SU group and 6.4% in the SC group. One-month major adverse cardiac events (MACE) occurred in 0.4% patients in the SU group, 7.1% in the SC group, and 2.7% in the F group (p=0.005). Risk of major adverse cardiac events (MACE) after one month was similar in patients in the SU and SC groups, with both groups faring better than those in the F group (respectively 23.7%, 17.9%, and 18.8%, p = 0.477). Similar trends for >1-month events were found for death and myocardial infarction (both p > 0.05), whereas repeat revascularization was more common after SU group (19.3% versus 14.3% and 6.3%, p = 0.005). Stent thrombosis was more common in SC group (0 versus 7.1% and 1.8%, p < 0.001).
Conclusion: Patients with uncomplicated CTO recanalization are at higher risk of restenosis and revascularization, whereas those with final success despite complications are at higher risk of stent thrombosis.

Keywords: Chronic total occlusion, Complication, Coronary artery disease, Failure, PTCA


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Author Contributions:
Andrea Gagnor – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Ferdinando Varbella – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Francesco Tomassini – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Sara Giolitto – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Cristina Rolfo – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Emanuele Tizzani – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Enrico Cerrato – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Alfonso Gambino – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Elisa Favro – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Rosario Tripodi – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Maria Cristina Rosa Brusin – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Paolo Gyai Pron – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Mariangela Peruzzi – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Giuseppe Biondi-Zoccai – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2016 Andrea Gagnor et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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