Hospital São José do Avaí, Itaperuna, RJ - Brasil.
Instituto Cardiovascular de Linhares UNICOR, Linhares, ES - Brasil.
Arq Bras Cardiol. 2023 May 1;120(4):e20210462. doi: 10.36660/abc.20210462. eCollection 2023.
Major advances have been seen in techniques and devices for performing percutaneous coronary interventions (PCIs) for chronic total occlusions (CTOs), but there are limited real-world practice data from developing countries.
To report clinical and angiographic characteristics, procedural aspects, and clinical outcomes of CTO PCI performed at dedicated centers in Brazil.
Included patients underwent CTO PCI at centers participating in the LATAM CTO Registry, a Latin American multicenter registry dedicated to prospective collection of these data. Inclusion criteria were procedures performed in Brazil, age 18 years or over, and presence of CTO with PCI attempt. CTO was defined as a 100% lesion in an epicardial coronary artery, known or estimated to have lasted at least 3 months.
Data on 1196 CTO PCIs were included. Procedures were performed primarily for angina control (85%) and/or treatment of moderate/severe ischemia (24%). Technical success rate was 84%, being achieved with antegrade wire approaches in 81% of procedures, antegrade dissection and re-entry in 9%, and retrograde approaches in 10%. In-hospital adverse cardiovascular events occurred in 2.3% of cases, with a mortality rate of 0.75%.
CTOs can be treated effectively in Brazil by using PCI, with low complication rates. The scientific and technological development observed in this area in the past decade is reflected in the clinical practice of dedicated Brazilian centers.
经皮冠状动脉介入治疗(PCI)慢性完全闭塞病变(CTO)的技术和器械已取得重大进展,但来自发展中国家的真实世界实践数据有限。
报告在巴西专门中心进行 CTO PCI 的临床和血管造影特征、手术方面和临床结果。
纳入在参与拉丁美洲 CTO 注册研究的中心接受 CTO PCI 的患者,该注册研究是一个拉丁美洲多中心注册研究,专门用于前瞻性收集这些数据。纳入标准为在巴西进行的手术、年龄 18 岁或以上,以及存在 CTO 并有 PCI 尝试。CTO 定义为心外膜冠状动脉 100%病变,已知或估计持续至少 3 个月。
共纳入 1196 例 CTO PCI。手术主要是为了控制心绞痛(85%)和/或治疗中度/重度缺血(24%)。技术成功率为 84%,81%的手术采用正向导丝方法,9%采用正向夹层和再进入方法,10%采用逆行方法。住院期间发生不良心血管事件的比例为 2.3%,死亡率为 0.75%。
在巴西,通过 PCI 可以有效治疗 CTO,且并发症发生率低。过去十年中该领域观察到的科学和技术发展反映在巴西专门中心的临床实践中。