Guide catheter extension use are associated with higher procedural success in chronic total occlusion percutaneous coronary interventions
Guide catheter extension use are associated with higher procedural success in chronic total occlusion percutaneous coronary interventions
Data
2024
Autores
Filho, Evandro M.
Araujo, Gustavo N.
Machado, Guilherme P.
Padilla, Lucio
Paula, João E. T. de
Botelho, Antonio C.
Campos, Carlos M.
Quesada, Franklin L. H.
Alcantara, Marco
Santiago, Ricardo
Journal Title
Journal ISSN
Volume Title
Publisher
Catheterization and Cardiovascular Interventions
Resumo
Background: Guide catheter extensions (GCEs) increase support and facilitate
equipment delivery, but aggressive instrumentation may be associated with a higher
risk of complications.
Aim: Our aim was to assess the impact of GCEs on procedural success and
complications in patients submitted to chronic total occlusion (CTO) percutaneous
coronary intervention (PCI).
Methods: We analyzed data from the multicenter LATAM CTO Registry. Procedural
success was defined as <30% residual stenosis and TIMI 3 distal flow. Major adverse
cardiac and cerebrovascular events (MACCE) was defined as the composite of all‐cause
death, myocardial infarction, target vessel revascularization, and stroke. Propensity score
matching (PSM) was used to compare outcomes with and without GCE use.
Results: From August 2010 to August 2021, 3049 patients were included. GCEs
were used in 438 patients (14.5%). In unadjusted analysis, patients in the GCE group
were older and had more comorbidities. The median J‐CTO score and its
components were higher in the GCE group. After PSM, procedural success was
higher with GCE use (87.7% vs. 80.5%, p = 0.007). The incidence of coronary
perforation (odds ratio [OR]: 1.46, 95% confidence interval [CI]: 0.78–2.71,
p = 0.230), bleeding (OR: 1.99, 95% CI: 0.41–2.41, p = 0.986), in‐hospital death
(OR: 1.39, 95% CI: 0.54–3.62, p = 0.495) and MACCE (OR: 1.07, 95% CI: 0.52–2.19,
p = 0.850) were similar in both groups.
Conclusion: In a contemporary, multicenter cohort of patients undergoing CTO PCI,
GCEs were used in older patients, with more comorbidities and complex anatomy.
After PSM, GCE use was associated with higher procedural success, and similar
incidence of adverse outcomes.
Description
Palavras-chave
Chronic total occlusion, coronary artery disease, guide extension catheter, percutaneous
coronary intervention.
Citação
Filho EM, Araujo GN, Machado GP, Padilla L, de Paula JET, Botelho AC, Campos CM, Quesada FLH, Alcantara M, Santiago R, de Los Santos FD, Oliveira MD, Ribeiro MH, Perez L, Pinto ME, Côrtes LA, Piccaro P, Brilakis ES, Quadros AS. Guide catheter extension use are associated with higher procedural success in chronic total occlusion percutaneous coronary interventions. Catheter Cardiovasc Interv. 2024 Mar;103(4):539-547. doi: 10.1002/ccd.30987.