부산대학교 도서관

Introduction: The elderly is frequently related to frailty, comorbidities, and higher short- and long-term complications in chronic total occlusion (CTO) percutaneous coronary intervention (PCI). The data was scarce. Thus, we aim to study the feasibility, safety, and outcome of CTO-PCI among the elderly aged <75 years versus ≥75 years.Methods: We performed a consecutive retrospective analysis of 258 CTO-PCI attempted at Okamura Memorial Hospital, Japan, from September 2015 to April 2021 via the electronic health record. It was categorized into <75 years and ≥75 years. All patients were analyzed for demographic, PCI, and follow-up details. We define target lesion failure (TLF) as the composite of cardiac-related death, target-vessel myocardial infarction (TVMI), and clinically driven target lesion revascularization (TLR). Regression analysis was done to identify specific risk factors for TLF.Results: Among attempted CTO-PCI, 177 (68.6%) <75 years and 81 (31.4%) ≥75 years. There was no significant short-term or in-hospital complication between both groups, except a significantly higher wire or vessel perforation in the elderly (4.0% vs. 12.3%). Left main CTO-PCI was more frequent in the elderly (2.3% vs. 8.8%). The high success rate was no difference between both groups (97.7% vs. 97.5%), with a very high number of IVUS used in both groups (98.9% vs. 100%). The 1-year TLF was insignificant between both groups (10.2% vs. 8.6%). The contrast volume and non-hypertensive patients were found to significantly increase the risk of TLF in the elderly ≥75 Years (OR 1.02 - 17.93).Conclusion: Our study demonstrated that CTO-PCI in elderly patients is feasible, safe, and with excellent mid-term TLF outcomes compared with the younger patients. The identified risk factors related to TLF may be able to guide the management strategy in this group of patients. Thus, CTO in the elderly should not be deprived of an invasive PCI strategy when indicated.