Association of prolonged fluoroscopy time with procedural success of percutaneous coronary intervention for stable coronary artery disease with and without chronic total occlusion

• Verfasst von: Tajti, Péter [VerfasserIn]
• Verfasst von: Ayoub, Mohamed [VerfasserIn]
• Verfasst von: Nührenberg, Thomas [VerfasserIn]
• Verfasst von: Ferenc, Miroslaw [VerfasserIn]
• Verfasst von: Behnes, Michael [VerfasserIn]
• Verfasst von: Büttner, Heinz-Joachim [VerfasserIn]
• Verfasst von: Neumann, Franz-Josef [VerfasserIn]
• Verfasst von: Mashayekhi, Kambis [VerfasserIn]
• Titel: Association of prolonged fluoroscopy time with procedural success of percutaneous coronary intervention for stable coronary artery disease with and without chronic total occlusion
• Verf.angabe: Peter Tajti, Mohamed Ayoub, Thomas Nuehrenberg, Miroslaw Ferenc, Michael Behnes, Heinz Joachim Buettner, Franz-Josef Neumann and Kambis Mashayekhi
• E-Jahr: 2021
• Jahr: 3 April 2021
• Umfang: 12 S.
• Fussnoten: Gesehen am 10.08.2021
• Titel Quelle: Enthalten in: Journal of Clinical Medicine
• Ort Quelle: Basel : MDPI, 2012
• Jahr Quelle: 2021
• Band/Heft Quelle: 10(2021), 7, Artikel-ID 1486, Seite 1-12
• ISSN Quelle: 2077-0383
• DOI: doi:10.3390/jcm10071486
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: chronic total occlusion
• Sach-SW: complex coronary artery disease
• Sach-SW: outcomes
• Sach-SW: percutaneous coronary intervention
• K10plus-PPN: 1766014658

Abstract

Background: In percutaneous coronary interventions (PCI), the impact of prolonged fluoroscopy time (FT) on procedural outcomes is poorly studied. Methods and Results: We analyzed the outcomes of 12,538 consecutive elective PCIs. The primary endpoint was procedure failure (PF), the composite of technical failure, and adverse in-hospital events including all-cause death, myocardial infarction, stroke, and target vessel revascularization (MACCE), as well as pericardial tamponade. We stratified the procedures as PCI for chronic total occlusion (CTO, n = 2720) and PCI for non-CTO (n = 9818). Logistic regression demonstrated a significant association between fluoroscopy time and procedural failure with a significant interaction with PCI type (both p < 0.001). The odds ratios (OR) of procedural failure for a 10-min increment in FT were 1.15 (confidence interval (CI) 95% 1.12-1.18, p < 0.001) in non-CTO PCI and 1.05 (CI 95% 1.03-1.06, p < 0.001) in CTO PCI. The optimal cut-point for prediction of PF was 21.1 min in non-CTO PCI (procedural success in 98.4% versus 95.3%, adjusted OR for PF 2.79 (CI 95% 1.93-4.04), p < 0.001) and 41 min in CTO PCI (procedural success in 92.3% versus 83.8%, adjusted OR for PF 2.18 (CI 95% 1.64-2.94), p < 0.001). In CTO PCI, the increase in PF with FT was largely driven by technical failure (adjusted OR 2.25 (CI 95% 1.65-3.10), p < 0.001), whereas in non-CTO PCI, it was driven by major complications (adjusted OR 2.94 (CI 95% 1.93-4.53), p < 0.001). Conclusions: Prolonged FT is strongly associated with procedural failure in both non-CTO and CTO PCI. In CTO PCI, this relation is shifted towards longer FT. The mechanisms of procedural failure differ between CTO and non-CTO PCI.