Coronary disease & ACSCohort study
Percutaneous Coronary Intervention for Aorto-Ostial Chronic Total Occlusion
- Registry-based observational study
- multicentre registry
Authors' conclusion
Aorto-ostial CTOs are more complex and frequently require a retrograde approach. The availability of suitable interventional collateral channels is crucial for the success of these procedures.
Study context
- Population
- Patients with ostial chronic total occlusion (CTO) undergoing percutaneous coronary intervention (PCI), Japanese CTO-PCI Expert Registry, January 2014 to December 2022ostial CTO
- Participants
- 420 patients
- Exposure
- Aorto-ostial CTO vs non-aorto-ostial CTO
- Aorto-ostial CTOn = 218
Main finding
As reported in the abstract
Technical success, aorto-ostial CTO
Aorto-ostial CTO
88%
191 of 218
- Ostial CTO among all CTO PCI cases
- 420 of 10,814 (3.9%)
- Aorto-ostial CTO among ostial CTO
- 218 of 420 (52%)
Observational data: associations, not effects.
Further findings
Lesion characteristics and strategy
- Aorto-ostial CTOs had longer lesions and more distal target lumen ambiguity, calcification and tortuosity vs non-aorto-ostial CTOs
- Retrograde approach more common in aorto-ostial CTO; retrograde direct crossing most successful, especially in flush CTO
Predictors of unsuccessful aorto-ostial CTO PCI (multivariate logistic analysis)
- Difficult guiding catheter engagement, collateral channel estimation (J-Channel score) and tortuosity significantly associated with failure
Original publication
Percutaneous Coronary Intervention for Aorto-Ostial Chronic Total Occlusion. JACC Cardiovasc Interv. Published 14 October 2024. doi:10.1016/j.jcin.2024.08.028
Summarised from the published abstract; every number is checked against it