[Interventional strategies and perioperative complications of chronic total coronary occlusion in combination with bifurcation lesions].

Y F Guo, H Y Peng, Y J Zhao, Y Lyu, P Wang, Y Lyu, J H Liu
Author Information
  1. Y F Guo: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China.
  2. H Y Peng: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China.
  3. Y J Zhao: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China.
  4. Y Lyu: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China.
  5. P Wang: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China.
  6. Y Lyu: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China.
  7. J H Liu: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China.

Abstract

To analyze the clinical characteristics of chronic total coronary occlusion (CTO) combined with bifurcation lesions and the features of coronary intervention and perioperative complications. This study adopted retrospective cross-sectional research methods and included 673 patients who underwent interventional therapy for chronic total occlusion in Beijing Anzhen Hospital. According to whether there were side branches (diameter ≥2 mm) within 5 mm before and after the CTO occlusion segment, patients were divided into bifurcation group (337 cases) and non-bifurcation group (336 cases). The measurement data did not conform to the normal distribution and were represented as (, ). The clinical risk factors, coronary angiography characteristics, interventional treatment strategies and perioperative complications were compared between the two groups. The patients in the bifurcation group were 60 (51, 65) years old, and 86.6% (292 cases) were male; the patients in the non-bifurcation group were 60 (52, 66) years old, and 83.0% (279 cases) were male.Coronary artery disease in all patients was mainly multivessel disease, of which three-vessel disease accounted for 59.9% (403 cases) and double-vessel disease accounted for 25.4% (171 cases).The target vessel in the bifurcation group was predominantly left anterior descending artery (62.3%, 210 cases), and the target vessel in the non-bifurcation group was more common in the right coronary artery (56%, 188 cases). The target vessel diameter was larger in the bifurcation group (2.91(2.71, 3.24) mm vs 2.80(2.55, 3.13) mm, <0.001). Most patients used the antegrade technique (88%, 592 cases), and the use of antegrade technique in the bifurcation group (91.9%, 307 cases) was higher than that in the non-bifurcation group (84.8%, 285 cases) (=0.012). After CTO-PCI, 72.8% (490 cases) of patients achieved successful angiography. A total of 73 patients (10.8%) had perioperative complications, and there was no statistical difference between the two groups. However, the incidence of perioperative myocardial infarction was higher in the bifurcation group (5.9%, 20 cases) than non-bifurcation group (2.7%, 9 cases) (=0.038). CTO complicated with bifurcation lesions are very common in clinical practice. Most patients with CTO have multiple coronary artery disease at the same time. The target vessel is more common in the left anterior descending artery, and the diameter of the vessel is larger. It is more common to use antergrade technique, accompanied by more perioperative myocardial infarctions.

Grants

  1. 81970291/National Natural Science Foundation of China

MeSH Term

Aged
Chronic Disease
Coronary Angiography
Coronary Occlusion
Cross-Sectional Studies
Humans
Male
Percutaneous Coronary Intervention
Retrospective Studies
Treatment Outcome

Word Cloud

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