Prevalence and Outcomes of Percutaneous Coronary Interventions for Ostial Chronic Total Occlusions: Insights From a Multicenter Chronic Total Occlusion Registry

• Published in: Canadian journal of cardiology 2018-10, Vol.34 (10), p.1264-1274
• Main Authors: Tajti, Peter, Burke, M. Nicholas, Karmpaliotis, Dimitri, Alaswad, Khaldoon, Jaffer, Farouc A., Yeh, Robert W., Patel, Mitul, Mahmud, Ehtisham, Choi, James W., Doing, Anthony H., Datilo, Phil, Toma, Catalin, Smith, A.J. Conrad, Uretsky, Barry, Holper, Elizabeth, Garcia, Santiago, Krestyaninov, Oleg, Khelimskii, Dimitrii, Koutouzis, Michalis, Tsiafoutis, Ioannis, Moses, Jeffrey W., Lembo, Nicholas J., Parikh, Manish, Kirtane, Ajay J., Ali, Ziad A., Doshi, Darshan, Jaber, Wissam, Samady, Habib, Rangan, Bavana V., Xenogiannis, Iosif, Ungi, Imre, Banerjee, Subhash, Brilakis, Emmanouil S.
• Format: Article
• Language: English
• Subjects: Chronic Disease; Coronary Angiography; Coronary Occlusion - diagnosis; Coronary Occlusion - epidemiology; Coronary Occlusion - surgery; Europe - epidemiology; Female; Hospital Mortality - trends; Humans; Male; Percutaneous Coronary Intervention - statistics & numerical data; Prevalence; Registries; Risk Factors; Time Factors; Treatment Outcome; United States - epidemiology
• ISSN: 0828-282X; 1916-7075
• DOI: 10.1016/j.cjca.2018.07.472

Ostial chronic total occlusions (CTOs) can be challenging to recanalize. We sought to examine the prevalence, angiographic presentation, and procedural outcomes of ostial (side-branch ostial and aorto-ostial) CTOs among 1000 CTO percutaneous coronary interventions (PCIs) performed in 971 patients between 2015 and 2017 at 14 centres in the US, Europe, and Russia. Ostial CTOs represented 16.9% of all CTO PCIs: 9.6% were aorto-ostial, and 7.3% were side-branch ostial occlusions. Compared with nonostial CTOs, ostial CTOs were longer (44 ± 33 vs 29 ± 19 mm, P < 0.001) and more likely to have proximal-cap ambiguity (55% vs 33%, P < 0.001), moderate/severe calcification (67% vs 45%, P