Instituto de Cardiologia do Rio Grande do Sul, Porto Alegre, Brazil.
Sociedade Brasileira de Hemodinâmica e Cardiologia Intervencionista, Brazil.
Catheter Cardiovasc Interv. 2020 Nov;96(5):1046-1055. doi: 10.1002/ccd.28744. Epub 2020 Jan 28.
To report clinical, angiographic characteristics, outcomes, and predictors of unsuccessful procedures in patients who underwent chronic total occlusion (CTO) percutaneous coronary interventions (PCI) in Latin America.
CTO PCI has been increasingly performed worldwide, but there is a lack of information in this region.
An international multicenter registry was developed to collect data on CTO PCI performed in centers in Latin America. Patient, angiographic, procedural and outcome data were evaluated. Predictors of unsuccessful procedures were assessed by multivariable analysis.
We have included data related to 1,040 CTO PCIs performed in seven countries in Latin America (Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, and Puerto Rico). The mean age was 64 ± 10 years, and CTO PCI was performed mainly for angina control (81%) or treatment of a large ischemic area (30%). Overall technical success rate was 82.5%, and it was achieved with antegrade wire escalation in 81%, antegrade dissection/re-entry in 8% and with retrograde techniques in 11% of the successful procedures. Multivariable analysis identified moderate/severe calcification, a blunt proximal cap and a previous attempt as independent predictors of unsuccessful procedures. In-hospital major adverse cardiovascular events (MACE) occurred in 3.1% of the cases, death in 1% and cardiac tamponade in 0.9% CONCLUSIONS: CTO PCI in Latin America has been performed mainly for ischemia relief. Procedures were associated with a success rate above 80% and low incidence of MACE. Predictors of unsuccessful procedures were similar to those previously reported in the literature.
报告在拉丁美洲进行慢性完全闭塞（CTO）经皮冠状动脉介入治疗（PCI）的患者的临床、血管造影特征、结果和手术不成功的预测因素。
CTO PCI 已在全球范围内得到越来越多的应用，但该地区缺乏相关信息。
开发了一个国际多中心登记处，以收集拉丁美洲中心进行的 CTO PCI 数据。评估了患者、血管造影、手术和结果数据。通过多变量分析评估手术不成功的预测因素。
我们纳入了来自拉丁美洲七个国家（阿根廷、巴西、智利、哥伦比亚、厄瓜多尔、墨西哥和波多黎各）的 1040 例 CTO PCI 相关数据。患者平均年龄为 64±10 岁，CTO PCI 主要用于控制心绞痛（81%）或治疗大面积缺血区（30%）。整体技术成功率为 82.5%，其中 81%采用正向导丝升级、8%采用正向夹层/再进入、11%采用逆行技术成功。多变量分析发现中度/重度钙化、钝性近端帽和先前尝试是手术不成功的独立预测因素。住院期间主要不良心血管事件（MACE）发生率为 3.1%，死亡率为 1%，心脏压塞发生率为 0.9%。
拉丁美洲的 CTO PCI 主要用于缓解缺血。手术成功率超过 80%，MACE 发生率低。手术不成功的预测因素与文献中先前报道的相似。
