TY - JOUR
T1 - Chronic total occlusion percutaneous coronary intervention of anomalous coronary arteries
T2 - insights from the PROGRESS CTO registry
AU - Hirata, Gustavo M.
AU - Rempakos, Athanasios
AU - Walker Boyd, A.
AU - Alexandrou, Michaella
AU - Mutlu, Deniz
AU - Choi, James W.
AU - Poommipanit, Paul
AU - Khatri, Jaikirshan J.
AU - Young, Laura
AU - Davies, Rhian
AU - Gorgulu, Sevket
AU - Jaffer, Farouc A.
AU - Chandwaney, Raj
AU - Jefferson, Brian
AU - Elbarouni, Basem
AU - Azzalini, Lorenzo
AU - Kearney, Kathleen E.
AU - Alaswad, Khaldoon
AU - Basir, Mir B.
AU - Krestyaninov, Oleg
AU - Khelimskii, Dmitrii
AU - Aygul, Nazif
AU - Abi-Rafeh, Nidal
AU - ElGuindy, Ahmed
AU - Goktekin, Omer
AU - Rangan, Bavana V.
AU - Mastrodemos, Olga C.
AU - Al-Ogaili, Ahmed
AU - Sandoval, Yader
AU - Burke, M. Nicholas
AU - Brilakis, Emmanouil S.
AU - Frizzell, Jarrod D.
N1 - Publisher Copyright:
© 2024 Wiley Periodicals LLC.
PY - 2024/11/15
Y1 - 2024/11/15
N2 - Background: There is limited information about the frequency and outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in anomalous coronary arteries (ACA). Methods: We examined the clinical and angiographic characteristics and procedural outcomes of CTO PCI in ACA among 14,173 patients who underwent 14,470 CTO PCIs at 46 US and non-US centers between 2012 and 2023. Results: Of 14,470 CTO PCIs, 36 (0.24%) were CTO PCIs in an ACA. ACA patients had similar baseline characteristics as those without an ACA. The type of ACA in which the CTO lesion was found were as follows: anomalous origin of the right coronary artery (ARCA) (17, 48.5%), anomalous origin of left circumflex coronary artery (9, 25.7%), left anterior descending artery and left circumflex artery with separate origins (4, 11.4%), anomalous origin of the left anterior descending artery (2, 5.7%), dual left anterior descending artery (2, 5.7%) and woven coronary artery 1 (2.8%). The Japan CTO score was similar between both groups (2.17 ± 1.32 vs 2.38 ± 1.26, p = 0.30). The target CTO in ACA patients was more likely to have moderate/severe tortuosity (44% vs 28%, p = 0.035), required more often use of retrograde approach (27% vs 12%, p = 0.028), and was associated with longer procedure (142.5 min vs 112.00 min [74.0, 164.0], p = 0.028) and fluoroscopy (56 min [40, 79 ml] vs 42 min [25, 67], p = 0.014) time and higher contrast volume (260 ml [190, 450] vs 200 ml [150, 300], p = 0.004) but had similar procedural (91.4% vs 85.6%, p = 0.46) and technical (91.4% vs 87.0%, p = 0.59) success. No major adverse cardiac events (MACE) were seen in ACA patients (0% [0] vs 1.9% [281] in non-ACA patients, p = 1.00). Two coronary perforations were reported in ACA CTO PCI (p = 0.7 vs. non-ACA CTO PCI). Conclusions: CTO PCI of ACA comprise 0.24% of all CTO PCIs performed in the PROGRESS CTO registry and was associated with higher procedural complexity but similar technical and procedural success rates and similar MACE compared with non-ACA CTO PCI.
AB - Background: There is limited information about the frequency and outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in anomalous coronary arteries (ACA). Methods: We examined the clinical and angiographic characteristics and procedural outcomes of CTO PCI in ACA among 14,173 patients who underwent 14,470 CTO PCIs at 46 US and non-US centers between 2012 and 2023. Results: Of 14,470 CTO PCIs, 36 (0.24%) were CTO PCIs in an ACA. ACA patients had similar baseline characteristics as those without an ACA. The type of ACA in which the CTO lesion was found were as follows: anomalous origin of the right coronary artery (ARCA) (17, 48.5%), anomalous origin of left circumflex coronary artery (9, 25.7%), left anterior descending artery and left circumflex artery with separate origins (4, 11.4%), anomalous origin of the left anterior descending artery (2, 5.7%), dual left anterior descending artery (2, 5.7%) and woven coronary artery 1 (2.8%). The Japan CTO score was similar between both groups (2.17 ± 1.32 vs 2.38 ± 1.26, p = 0.30). The target CTO in ACA patients was more likely to have moderate/severe tortuosity (44% vs 28%, p = 0.035), required more often use of retrograde approach (27% vs 12%, p = 0.028), and was associated with longer procedure (142.5 min vs 112.00 min [74.0, 164.0], p = 0.028) and fluoroscopy (56 min [40, 79 ml] vs 42 min [25, 67], p = 0.014) time and higher contrast volume (260 ml [190, 450] vs 200 ml [150, 300], p = 0.004) but had similar procedural (91.4% vs 85.6%, p = 0.46) and technical (91.4% vs 87.0%, p = 0.59) success. No major adverse cardiac events (MACE) were seen in ACA patients (0% [0] vs 1.9% [281] in non-ACA patients, p = 1.00). Two coronary perforations were reported in ACA CTO PCI (p = 0.7 vs. non-ACA CTO PCI). Conclusions: CTO PCI of ACA comprise 0.24% of all CTO PCIs performed in the PROGRESS CTO registry and was associated with higher procedural complexity but similar technical and procedural success rates and similar MACE compared with non-ACA CTO PCI.
KW - anomalous coronary artery
KW - chronic total occlusion
KW - percutaneous coronary intervention
UR - https://www.scopus.com/pages/publications/85205575046
U2 - 10.1002/ccd.31248
DO - 10.1002/ccd.31248
M3 - Article
AN - SCOPUS:85205575046
SN - 1522-1946
VL - 104
SP - 1148
EP - 1158
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 6
ER -