In:
Journal of Personalized Medicine, MDPI AG, Vol. 13, No. 3 ( 2023-03-13), p. 515-
Abstract:
Background: Balloon uncrossable lesions are defined as lesions that cannot be crossed with a balloon after successful guidewire crossing. Methods: We analyzed the association between balloon uncrossable lesions and procedural outcomes of 8671 chronic total occlusions (CTOs) percutaneous coronary interventions (PCIs) performed between 2012 and 2022 at 41 centers. Results: The prevalence of balloon uncrossable lesions was 9.2%. The mean patient age was 64.2 ± 10 years and 80% were men. Patients with balloon uncrossable lesions were older (67.3 ± 9 vs. 63.9 ± 10, p 〈 0.001) and more likely to have prior coronary artery bypass graft surgery (40% vs. 25%, p 〈 0.001) and diabetes mellitus (50% vs. 42%, p 〈 0.001) compared with patients who had balloon crossable lesions. In-stent restenosis (23% vs. 16%. p 〈 0.001), moderate/severe calcification (68% vs. 40%, p 〈 0.001), and moderate/severe proximal vessel tortuosity (36% vs. 25%, p 〈 0.001) were more common in balloon uncrossable lesions. Procedure time (132 (90, 197) vs. 109 (71, 160) min, p 〈 0.001) was longer and the air kerma radiation dose (2.55 (1.41, 4.23) vs. 1.97 (1.10, 3.40) min, p 〈 0.001) was higher in balloon uncrossable lesions, while these lesions displayed lower technical (91% vs. 99%, p 〈 0.001) and procedural (88% vs. 96%, p 〈 0.001) success rates and higher major adverse cardiac event (MACE) rates (3.14% vs. 1.49%, p 〈 0.001). Several techniques were required for balloon uncrossable lesions. Conclusion: In a contemporary, multicenter registry, 9.2% of the successfully crossed CTOs were initially balloon uncrossable. Balloon uncrossable lesions exhibited lower technical and procedural success rates and a higher risk of complications compared with balloon crossable lesions.
Type of Medium:
Online Resource
ISSN:
2075-4426
Language:
English
Publisher:
MDPI AG
Publication Date:
2023
detail.hit.zdb_id:
2662248-8
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