Contemporary Incidence, Management, and Long-Term Outcomes of Percutaneous Coronary Interventions for Chronic Coronary Artery Total Occlusions: Insights From the VA CART Program
作者： Thomas T. Tsai , Maggie A. Stanislawski , Kendrick A. Shunk , Ehrin J. Armstrong , Gary K. Grunwald
DOI: 10.1016/J.JCIN.2017.02.044
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摘要: Abstract Objectives The aim of this study was to describe the contemporary incidence chronic total occlusions (CTOs) and the success rates CTO percutaneous coronary intervention (PCI), as well complications and long-term outcomes these patients. Background prevalence management CTOs is understudied. Methods Consecutive veterans undergoing angiography at 79 Veterans Affairs sites between 2007 2013 were examined. Detailed baseline clinical, angiographic, follow-up evaluated using national data from Clinical Assessment Reporting Tracking program. Results Among 111,273 patients with obstructive artery disease, 29,399 (26.4%) had ≥1 CTO, most commonly in right distribution (n = 18,986 [64.6%]). Elective PCI attempted 2,394 (8.1%), a procedural rate 79.7%. odds increased over years (odds ratio: 1.08; 95% confidence interval [CI]: 1.01 1.16; p = 0.03). Compared failed PCI, successful CTO associated decreased adjusted risk for mortality (hazard 0.67; CI: 0.47 0.95; 0.02) bypass graft surgery 0.14; 0.08 0.24; p Conclusions Approximately 1 4 disease on had CTOs. who went elective PCI, successful need subsequent surgery.
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