다혈관 관상동맥 만성폐색병변의 경피적 관상동맥 중재술에 있어 치료 전략에 따른 시술 전후 합병증과 시술 적절성 및 장기 임상 경과에 대한 분석

Abstract

Objective: To evaluate periprocedural complication and feasibility and long-term clinical outcomes about percutaneous coronary intervention (PCI) of multivessel-chronic total occlusion (MV-CTO) according to the treatment strategies. Background: Limited data are available on PCI for MV-CTO, which is rarely identified in CTO patients. Methods: In total, 164 consecutive patients who underwent 232 PCIs for MV-CTO at single tertiary cardiac center in South Korea were included. MV-CTO was defined as the identification of CTO lesions in more than two coronary arteries. The periprocedural complication and feasibility and long-term clinical outcome were analyzed according to CTO PCI strategies. Results: 96 patients underwent just one CTO PCI (96 cases) and 68 patients had two CTO PCIs (136 cases). The mean Japanese Multicenter CTO Registry (J-CTO) score was 2.0 ± 1.7. Of the 232 CTO procedures, 198 cases were successful in 85.3% and the success rate of all two CTO PCI was 75.5%. The staged PCI seemed to be more successful than the simultaneous second PCI (94.5% vs 80.5%, p = 0.156). The incidence of periprocedural complication and the target vessel failure, mainly driven by target vessel revascularization did not differ according to PCI strategies. Conclusion: PCI for MV-CTO showed a high success rate with an acceptable periprocedural complication and long-term rate of target-vessel failure. If the patient is stable and the CTO lesion is anatomically suitable for PCI, it is recommended to revascularize completely.