Suleman Muhammad, Arif Nayyar, Khan Muhammad Ishaq, Jibran Muhammad Saad, Jamil Muhammad, Khan Shafi Ullah, Khan Shah Sawar, Maken Ghulam Rasool
Department of Cardiology, Armed Forces Institute of Cardiology, Rawalpindi, Punjab, Pakistan.
Department of Cardiology, Peshawar Institute of Cardiology, Peshawar, Khyber Pakhtunkhwa, Pakistan.
Egypt Heart J. 2024 May 23;76(1):62. doi: 10.1186/s43044-024-00490-6.
The limited availability of complex coronary intervention facilities and qualified operators, due to the high cost associated with chronic total occlusion (CTO) percutaneous intervention (PCI) equipment and a shortage of necessary skills, has led to a scarcity of capable medical centers in Pakistan. This study seeks to examine the outcomes and potential complications associated with CTO PCI procedures conducted at the Cardiac Catheterization Laboratories of a prominent national institute in Pakistan, which handles a large volume of cases.
Three hundred and six patients were included in the study in the study period of six months. The mean age was 59.49 (± 9.16) years: 256 (83.66%) were male and 50 (16.34%) were female. CTO was successfully re-vascularized in 237 (77.5%) with a complication rate of 13.7%. Two hundred and ninety-eight (97.39%) patients underwent an antegrade approach, while RCA was the most common target vessel (47.71%). Diabetes was the only significant associated risk factor with CTO PCI failure (30.43% vs. 30.43%, P-value = 0.015).
We achieved an excellent procedural success rate with a low complication rate. CTO procedural failure is associated with a higher complication rate, and diabetes is among the risk factors that lead to higher procedural failure.
由于慢性完全闭塞(CTO)经皮冠状动脉介入治疗(PCI)设备成本高昂以及缺乏必要技能,复杂冠状动脉介入设施和合格操作人员的可获得性有限,导致巴基斯坦有能力开展此类手术的医疗中心稀缺。本研究旨在调查在巴基斯坦一家处理大量病例的著名国立机构的心导管实验室进行的CTO PCI手术的结果及潜在并发症。
在为期6个月的研究期间,共有306例患者纳入研究。平均年龄为59.49(±9.16)岁:男性256例(83.66%),女性50例(16.34%)。237例(77.5%)患者的CTO成功实现血管再通,并发症发生率为13.7%。298例(97.39%)患者采用顺行路径,右冠状动脉是最常见的靶血管(47.71%)。糖尿病是与CTO PCI失败相关的唯一显著危险因素(30.43%对30.43%,P值=0.015)。
我们取得了出色的手术成功率,并发症发生率较低。CTO手术失败与较高的并发症发生率相关,糖尿病是导致手术失败率较高的危险因素之一。