Key result
Bifurcation CTO PCI achieves a ~92% recanalization success rate, predominantly with one-stent techniques.
Why the study?
Bifurcation lesions within chronic total occlusions (CTOs) represent a significant challenge in PCI, but their characteristics and treatment strategies are not well defined.
Observational (n=216)
No
Bifurcation lesions occur in nearly one-fifth of CTO PCIs and can be successfully treated in the vast majority of cases, most commonly with a provisional one-stent strategy.
Answers are grounded in this paper and cite their sources.
Bifurcation lesions add complexity to ~18% of CTO PCIs with high provisional success; leaves open optimal strategies in prospective multicenter data.
Background/Aim. Chronic total occlusions (CTOs) of the coronary artery are still one of the most complex procedures in the treatment of coronary arteries. If there is a bifurcation lesion within the CTO, it is certainly one of the biggest challenges for interventional cardiologists. Methods. We present a retrospective analysis of patients from our center who underwent percutaneous coronary intervention (PCI) with a bifurcation lesion within the CTO and a side branch with a diameter of 2 mm or more from January 2017 to December 2020. Results. Out of the total 216 patients in the four-year period, 38 (18%) had a bifurcation lesion within the CTO. The most common bifurcation lesions (50%) were on the left anterior descending artery, and the least frequent (21%) on the circumflex coronary artery. CTO recanalization was successful in 35 (92%) patients. The one-stent technique was used in 27 (77%) patients, while the two-stent technique was used in 8 (23%) patients. Conclusion. Bifurcation lesions in the context of PCI CTOs are a relatively common finding in coronary angiography and represent a special challenge for CTO operators. The provisional technique (one-stent technique) is the most common strategy for the treatment of bifurcation lesions in patients with CTO.
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Juričić et al. (2023) conducted an observational in Chronic total occlusions (CTO) (n=216). Percutaneous coronary intervention (PCI) was evaluated on CTO recanalization success. Percutaneous coronary intervention for bifurcation lesions within chronic total occlusions achieved a 92% recanalization success rate, predominantly using a one-stent technique.
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