The effect of simultaneous coronary angiography and percutaneous coronary intervention versus selective percutaneous coronary intervention on the surgical success rate in treating coronary chronic total occlusion / 介入放射学杂志

ABSTRACT

Objective To discuss the effect of simultaneous coronary angiography plus percutaneous coronary intervention(PCI)and selective PCI on the surgical success rate in treating coronary chronic total occlusion(CTO).Methods The clinical data of a total of 147 consecutive patients with coronary CTO,who received PCI treatment at the Jinhua Municipal Central Hospital of China between January 1,2020 and December 31,2022,were retrospectively analyzed.According to whether the patient received PCI immediately after coronary angiography or not,the patients were divided into simultaneous PCI group(n=64)and selective PCI group(n=83).The clinical data and surgical success rate were compared between the two groups.Multivariate logistic regression analysis was used to determine the factors affecting the success of the PCI surgery for coronary CTO.Results The lesion's length of coronary CTO in the simultaneous PCI group was 35 mm,which was obviously shorter than 50 mm in the selective PCI group(P=0.022).No statistically significant differences in the other angiographic findings existed between the two groups(all P＞0.05).The surgical success rate in the simultaneous PCI group was 78.1%,which was remarkably lower than 88.0%in the selective PCI group(P=0.034).Multivariate logistic regression analysis revealed that simultaneous PCI(OR=4.617,95%CI=1.900-11.221,P=0.001),no stump lesion(OR=4.381,95%CI=1.821-10.452,P=0.001),occlusion length≥20 mm(OR=2.462,95%CI=1.030-5.887,P=0.043),and surgical complications(OR=8.688,95%CI=1.573-47.971,P=0.013)were the independent factors influencing the success of PCI surgery for coronary CTO.Conclusion For the treatment of coronary CTO,the simultaneous coronary angiography and PCI treatment may increase the risk of surgical failure.(J Intervent Radiol,2024,3252-56)