Safety of Percutaneous Coronary Intervention for Chronic Total Occlusion in Patients With Multi-Vessel Disease: Sub-Analysis of the Japanese Retrograde Summit Registry

• Published in: Cardiovascular revascularization medicine 2021-04, Vol.25, p.36-42
• Main Authors: Katoh, Hiromasa, Yamane, Masahisa, Muramatsu, Toshiya, Okamura, Atsunori, Kashima, Yoshifumi, Matsuno, Shunsuke, Sakurada, Masami, Kijima, Mikihiro, Tanabe, Masaki, Habara, Maoto
• Format: Article
• Language: English
• Subjects: Chronic coronary total occlusion; Multiple vessel disease; Percutaneous coronary intervention
• ISSN: 1553-8389; 1878-0938
• DOI: 10.1016/j.carrev.2020.10.007

The success rate of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) has gradually increased thanks to the continuous development of devices and techniques. However, the impact of multi-vessel disease (MVD) on its success rate and safety is not well known. The clinical records of 5009 patients enrolled in the Japanese Retrograde Summit Registry and who had undergone PCI for CTO at 65 centers between 2012 and 2015 were reviewed. We compared the outcome for patients with and without MVD. Two thousand nine hundred and seventy-eight patients (59%) had MVD. Although there was no significant difference in the J-CTO score between the two groups [MVD group 1.51 ± 1.07 vs. SVD group 1.48 ± 1.07, p = 0.48], the procedural success rate of CTO-PCI in the MVD group was significantly lower than that in the SVD group (87.2% vs. 90.2%, p = 0.001). However, occurrence of procedure-related adverse events (4% vs. 5%, p = 0.11), total fluoroscopy (70 ± 45 min vs. 69 ± 50 min, p = 0.75) and procedural time (154 ± 86 min vs. 151 ± 89 min, p = 0.36), and total amount of contrast media (219 ± 102 mL vs. 222 ± 105 mL, p = 0.33) did not differ between the two groups. Although MVD had an impact on the success rate of CTO-PCI, it did not affect procedure-related adverse events. •One of the largest Japanese registries about coronary chronic total occlusion was analyzed.•Success rate of CTO PCI in patients with multi-vessel disease was lower than that with single-vessel disease.•CTO PCI in patients with multi-vessel disease is acceptable because procedural safety is equal between patients with multi- and single-vessel disease.