In France and Italy, approximately 240,000 percutaneous coronary angioplasties (PCI) are performed annually, with an increasing number of complex procedures, including those involving the left coronary common trunk, a bifurcation, chronic occlusion, or requiring Rotablator Rotary Atherectomy (ARota). The medical literature lacks sufficient data regarding several key aspects of complex angioplasty. These include the epidemiological characteristics of patients undergoing such procedures, the impact of irradiation delivered and the quantity of iodine injected on these lengthy procedures, their procedural complication rate, and in-hospital mortality.
A retrospective database of the hemodynamics department of the Centre Cardiologique du Nord and Clinica Mediterranea, comprising 15,630 consecutive angioplasties performed in unselected patients between February 1, 2008, and July 7, 2018, was used to identify complex angioplasties and standard angioplasties. Two categories of complex angioplasty were identified: complex angioplasty with a single complexity criterion and very complex angioplasty with two or more complexity criteria. These complex angioplasties were then compared with standard angioplasty (angioplasty with no complexity criteria). The following criteria were employed to delineate complex or very complex angioplasties: * Unprotected Left Coronary Common Trunk Angioplasty (UT-PCI) * Angioplasty with Rotablator Rotary Atherectomy (ARota-PCI) * Angioplasty of Chronic Coronary Occlusion (CCO-PCI) * Angioplasty of a Bifurcation Lesion (CBL-PCI) The following definitions pertain to the classification of angioplasty procedures: * Standard angioplasty: This encompasses angioplasty procedures that do not meet the criteria for complexity. * Complex angioplasty: This designation is applied to angioplasty procedures that meet at least one criterion for complexity. * Very complex angioplasty: This designation is applied to angioplasty procedures that meet at least two criteria for complexity.
Study Type
OBSERVATIONAL
Enrollment
15,630
The patient cohort included individuals who had been hospitalized with a diagnosis of either STEMI or non-STEMI. The procedure involved percutaneous coronary intervention (PCI) with the use of drug-eluting stents (DES).
The patient cohort included individuals who had been hospitalized with a diagnosis of either STEMI or non-STEMI. The procedure involved complex percutaneous coronary intervention (PCI) with the use of drug-eluting stents (DES).This designation is applied to angioplasty procedures that meet at least one criterion for complexity. The complex angioplasty involved patients with unprotected left coronary common trunk (UT-PCI), the use of rotablator rotary atherectomy (ARota-PCI), the angioplasty of chronic coronary occlusion (CCO-PCI), or the angioplasty of a bifurcation lesion (CBL-PCI).The highly intricate angioplasty procedure was conducted on patients who met at least two criteria indicative of complexity.
Death
The primary end point of the study is the rate of death
Time frame: 30 days
Death
The primary end point of the study is the rate of death
Time frame: 1 year
Death
The primary end point of the study is the rate of death
Time frame: 5 years
Myocardial Infarction
The primary end point of the study is the rate of myocardial infarction
Time frame: 30 days
Myocardial Infarction
The primary end point of the study is the rate of myocardial infarction
Time frame: 1 year
Myocardial Infarction
The primary end point of the study is the rate of myocardial infarction
Time frame: 5 years
Stent Thrombosis
The primary end point of the study is the rate of stent thrombosis
Time frame: 30 days
Stent Thrombosis
The primary end point of the study is the rate of stent thrombosis
Time frame: 1 year
Stent Thrombosis
The primary end point of the study is the rate of stent thrombosis
Time frame: 5 years
Acute Kidney Injury
The primary end point of the study is the rate of acute kidney injury
Time frame: 30 days
Acute Kidney Injury
The primary end point of the study is the rate of acute kidney injury
Time frame: 1 years
Coronary Obstruction Requiring Intervention
The primary end point of the study is the rate of coronary obstruction requiring intervention
Time frame: 30 days
Coronary Obstruction Requiring Intervention
The primary end point of the study is the rate of coronary obstruction requiring intervention
Time frame: 1 year
Coronary Obstruction Requiring Intervention
The primary end point of the study is the rate of coronary obstruction requiring intervention
Time frame: 5 years
Increase in Tnl and Tnt Levels
The primary end point of the study is the rate in increase of Tnl and Tnt levels
Time frame: 30 days
Increase in Tnl and Tnt Levels
The primary end point of the study is the rate in increase of Tnl and Tnt levels
Time frame: 1 year
Rehospitalization
The primary end point of the study is the rate of rehospitalization (coronary-related or procedure-related, including heart failure)
Time frame: 30 days
Rehospitalization
The primary end point of the study is the rate of rehospitalization (coronary-related or procedure-related, including heart failure)
Time frame: 1 year
Rehospitalization
The primary end point of the study is the rate of rehospitalization (coronary-related or procedure-related, including heart failure)
Time frame: 5 years
Target Vessel Revascularization
The secondary end point of the study is the rate of target vessel revascularization
Time frame: 1 year
Target Vessel Revascularization
The secondary end point of the study is the rate of target vessel revascularization
Time frame: 5 years
Target Lesion Revascularization
The secondary end point of the study is the rate of target lesion revascularization
Time frame: 1 year
Target Lesion Revascularization
The secondary end point of the study is the rate of target lesion revascularization
Time frame: 5 years
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