Articles Vol. 63 No. 4 (2022) 08/08/2022

COMPLICATIONS OF CHRONIC TOTAL OCCLUSION PERCUTANEOUS CORONARY INTERVENTION

Vu Hoang Vu1,2, Truong Quang Binh3,4
1 University of Medicine and Pharmacy Hospital
2 Bệnh viện Đại học Y Dược TP HCM
3 University of Medicine and Pharmacy
4 Đại học Y Dược TP HCM
Corresponding author: vu.vh@umc.edu.vn
DOI: 10.52163/yhc.v63i4.367
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Keywords
Complications, pertacuneous coronary intervention, chronic total occlusion, antegrade, retrograde.
Abstract

Background: Percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) lesions
continues to be a challenge, with a lower success rate and a higher risk of procedure-related
complications than intervention on non-chronic total occlusion lesions. Due to a paucity of data on
this phenomena in Vietnam, we undertook this study to learn more about the complications associated
with this complicated technique.
Objectives: Determining the rate and factors associated with procedural complications of CTO-PCI.
Subject – Method of Study: Observational study on eligible patients undergone percutaneous
coronary intervention for CTO lesions at the Ho Chi Minh City University Medical Center, Vietnam,
from April 2017 to June 2019.
Results: There were 194 CTO patients undergone percutaneous coronary intervention that were
enrolled in this study. The mean age was 67.3±11.3, in which male accounted for 73.7%. Comorbidities were hypertension (82.5%), old myocardial infarction (26.3%), previous PCI (26.3%),
diabetes mellitus (29.9%), chronic kidney disease (9.8%). There were 77.4% patients hospitalized
for acute coronary syndrome. Mean SYNTAX I score was 21.7±7.2, mean J-CTO score was 2.4±1.1.
Antegrade intervention strategy accounted for 83.0%, with LAD being the most intervened lesion
(55.7%). The overall success rate of the procedure was 87.1%. In-hospital procedural complications
noted in 16 cases (8.2%), included: coronary artery perforation (2.1%), coronary artery dissection
(1.5%), side-branch loss (1.0%), thrombosis (1.0%), procedure-related myocardial infarction (0.5%),
arrhythmia (1.5%), bleeding (0.5%). Factors related to procedural complications included: old age,
previous PCI.
Conclusion: Our study showed a low rate of CTO-PCI related procedural complications (8.2%).
Factors related to high complication risk were old age and previous PCI

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