TY - JOUR
T1 - Impact of prior coronary artery bypass grafting in patients undergoing chronic total occlusion-percutaneous coronary intervention
T2 - Procedural and clinical outcomes from the REgistry of Crossboss and Hybrid procedures in FrAnce, the NetheRlands, BelGium, and UnitEd Kingdom (RECHARGE)
AU - of all the RECHARGE investigators
AU - Budassi, Simone
AU - Zivelonghi, Carlo
AU - Dens, Joseph
AU - Bagnall, Alan J.
AU - Knaapen, Paul
AU - Avran, Alexandre
AU - Spratt, James C.
AU - Walsh, Simon
AU - Faurie, Benjamin
AU - Agostoni, Pierfrancesco
N1 - Funding Information: Benjamin Faurie is a Proctor for Boston Scientific. Simon Wash received research funding from Boston Scientific, Abbott Vascular and he is consultant for Abbott Vascular, Boston Scientific, Medtronic, Teleflex. The other authors have no conflict of interest to declare. Publisher Copyright: © 2020 Wiley Periodicals, Inc. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/1/1
Y1 - 2021/1/1
N2 - Aim: Chronic total occlusions (CTO) in patients with history of coronary artery bypass graft (CABG) show more advanced and complex atherosclerotic pathology. Aim of our study is to compare outcomes in patients undergoing CTO percutaneous coronary intervention (PCI) with previous CABG versus those without in the REgistry of Crossboss and Hybrid procedures in FrAnce the NetheRlands, BelGium and UnitEd Kingdom (RECHARGE). Methods & results: The RECHARGE cohort (1,252 patients) was divided in two groups according to the presence of previous CABG (217) or not. We also focused, in the post-CABG group, on a comparison between CTO in previously grafted vessels versus non-grafted vessels. The CTO complexity scores were higher and the success rate (71.9% vs. 88.7%, p <.001) was lower in the CABG group, this difference was driven by higher failure rates in high-complexity-score CTO. The rate of in-hospital complications was similar. In the post-CABG group, the procedural success of CTO located in previously grafted vessels versus those in vessels not previously grafted, was comparably suboptimal (73.1% vs. 68%, p =.47). Conclusion: Patients undergoing CTO PCI with prior CABG have a higher prevalence of comorbidities and more complex lesion characteristics. In the post-CABG population the success rate was significantly lower, particularly in high CTO complexity scores, though complication rates were comparable. In the post-CABG population, the CTO success rate was independent of the presence of a previous graft on the CTO vessel.
AB - Aim: Chronic total occlusions (CTO) in patients with history of coronary artery bypass graft (CABG) show more advanced and complex atherosclerotic pathology. Aim of our study is to compare outcomes in patients undergoing CTO percutaneous coronary intervention (PCI) with previous CABG versus those without in the REgistry of Crossboss and Hybrid procedures in FrAnce the NetheRlands, BelGium and UnitEd Kingdom (RECHARGE). Methods & results: The RECHARGE cohort (1,252 patients) was divided in two groups according to the presence of previous CABG (217) or not. We also focused, in the post-CABG group, on a comparison between CTO in previously grafted vessels versus non-grafted vessels. The CTO complexity scores were higher and the success rate (71.9% vs. 88.7%, p <.001) was lower in the CABG group, this difference was driven by higher failure rates in high-complexity-score CTO. The rate of in-hospital complications was similar. In the post-CABG group, the procedural success of CTO located in previously grafted vessels versus those in vessels not previously grafted, was comparably suboptimal (73.1% vs. 68%, p =.47). Conclusion: Patients undergoing CTO PCI with prior CABG have a higher prevalence of comorbidities and more complex lesion characteristics. In the post-CABG population the success rate was significantly lower, particularly in high CTO complexity scores, though complication rates were comparable. In the post-CABG population, the CTO success rate was independent of the presence of a previous graft on the CTO vessel.
KW - CTO percutaneous coronary intervention
KW - chronic total occlusion
KW - coronary artery disease
KW - coronary bypass grafts
UR - http://www.scopus.com/inward/record.url?scp=85085106292&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/ccd.28954
DO - https://doi.org/10.1002/ccd.28954
M3 - Article
C2 - 32369681
SN - 1522-1946
VL - 97
SP - E51-E60
JO - Catheterization and cardiovascular interventions
JF - Catheterization and cardiovascular interventions
IS - 1
ER -