title: Impact of prior coronary artery bypass graft surgery on chronic total occlusion revascularisation: insights from a multicentre US registry.
abstract: OBJECTIVE
  To investigate the impact of prior coronary artery bypass graft (CABG) surgery on the outcomes of percutaneous coronary intervention (PCI) for chronic total occlusions (CTO).
  
  
  METHODS
  Observational retrospective study.
  
  
  METHODS
  Three tertiary hospitals in the USA.
  
  
  METHODS
  1363 consecutive patients who underwent CTO PCI between 2006 and 2011.
  
  
  METHODS
  Procedural success and inhospital complications, which were compared between patients with and without prior CABG.
  
  
  RESULTS
  Compared to patients without prior CABG, those with prior CABG were older, had more comorbidities, were treated more frequently with the retrograde approach (46.7% vs 27.1%, p<0.001) and had lower technical success rates (79.7% vs 88.3%, p=0.015). Of the 24 (1.8%) major inhospital complications, 11 occurred in patients with prior CABG and 13 in patients without prior CABG (2.1% vs 1.5%, p=0.392). In multivariable analysis prior CABG was independently associated with lower technical success rate (OR 0.49, 95% CIs 0.35 to 0.70, p<0.001).
  
  
  CONCLUSIONS
  In a large multicentre registry, CTO PCI was frequently performed among patients with prior CABG, with higher use of the retrograde approach and similar complications but lower technical success rates compared to patients without prior CABG.
authors.affiliation: Department of Internal Medicine/Cardiology, VA North Texas Healthcare System, , Dallas, Texas, USA.
authors.forename: Tesfaldet T
authors.initials: TT
authors.lastname: Michael
authors.forename: Dimitri
authors.initials: D
authors.lastname: Karmpaliotis
authors.forename: Emmanouil S
authors.initials: ES
authors.lastname: Brilakis
authors.forename: Shuaib M
authors.initials: SM
authors.lastname: Abdullah
authors.forename: Ben L
authors.initials: BL
authors.lastname: Kirkland
authors.forename: Katrina L
authors.initials: KL
authors.lastname: Mishoe
authors.forename: Nicholas
authors.initials: N
authors.lastname: Lembo
authors.forename: Anna
authors.initials: A
authors.lastname: Kalynych
authors.forename: Harold
authors.initials: H
authors.lastname: Carlson
authors.forename: Subhash
authors.initials: S
authors.lastname: Banerjee
authors.forename: William
authors.initials: W
authors.lastname: Lombardi
authors.forename: David E
authors.initials: DE
authors.lastname: Kandzari
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States / Q000453:epidemiology