Scopus
YÖKSİS Eşleşti
The Retrograde Approach to Chronic Total Occlusion Percutaneous Coronary Interventions: Technical Analysis and Procedural Outcomes
JACC: Cardiovascular Interventions · Kasım 2023
YÖKSİS Kayıtları
The Retrograde Approach to Chronic Total Occlusion Percutaneous Coronary Interventions
JACC: Cardiovascular Interventions · 2023 SCI-Expanded
PROFESÖR NAZİF AYGÜL →
Makale Bilgileri
DergiJACC: Cardiovascular Interventions
Yayın TarihiKasım 2023
Cilt / Sayfa16 · 2748-2762
Scopus ID2-s2.0-85176401337
Özet
Background: Retrograde chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is associated with lower success and higher complication rates when compared with the antegrade approach. Objectives: This study sought to assess contemporary techniques and outcomes of retrograde CTO PCI. Methods: We examined the baseline characteristics, procedural techniques and outcomes of 4,058 retrograde CTO PCIs performed at 44 centers between 2012 and 2023. Major adverse cardiac events (MACE) included any of the following in-hospital events: death, myocardial infarction, repeat target vessel revascularization, pericardiocentesis, cardiac surgery, and stroke. Results: The average J-CTO (Multicenter CTO Registry in Japan) score was 3.1 ± 1.1. Retrograde crossing was successful in 60.5% and lesion crossing in 81.6% of cases. The collaterals pathways successfully used were septals in 62.0%, saphenous vein grafts in 17.4%, and epicardials in 19.1%. The technical and procedural success rates were 78.7% and 76.6%, respectively. When retrograde crossing failed, technical success was achieved in 50.3% of cases using the antegrade approach. In-hospital MACE was 3.5%. The clinical coronary perforation rate was 5.8%. The incidence of in-hospital MACE with retrograde true lumen crossing, just marker antegrade crossing, conventional reverse controlled antegrade and retrograde tracking (CART), contemporary reverse CART, extended reverse CART, guide-extension reverse CART, and CART was 2.1%, 0.8%, 5.5%, 3.0%, 2.1%, 3.2%, and 4.1%, respectively; P = 0.01). Conclusions: Retrograde CTO PCI is utilized in highly complex cases and yields moderate success rates with 5.8% perforation and 3.5% periprocedural MACE rates. Among retrograde crossing strategies, retrograde true lumen puncture was the safest. There is need for improvement of the efficacy and safety of retrograde CTO PCI.
Yazarlar (29)
1
Salman S. Allana
2
Spyridon Kostantinis
3
Athanasios Rempakos
4
Bahadir Simsek
5
Judit Karacsonyi
6
Michaella Alexandrou
7
James W. Choi
8
Khaldoon Alaswad
9
Oleg Krestyaninov
10
Dmitrii Khelimskii
11
Sevket Gorgulu
12
Rhian Davies
13
Stewart Benton
14
Dimitrios Karmpaliotis
15
Farouc A. Jaffer
16
Jaikirshan J. Khatri
17
Paul Poommipanit
18
Lorenzo Azzalini
19
Kathleen E. Kearney
20
Raj H. Chandwaney
21
William Nicholson
22
Wissam Jaber
23
Stephane Rinfret
24
Jarrod Frizzell
25
Taral Patel
26
Brian K. Jefferson
27
Nazif Aygül
28
Bavana V. Rangan
29
Emmanouil S. Brilakis
Anahtar Kelimeler
coronary artery disease
coronary chronic total occlusion
percutaneous coronary intervention
retrograde
Kurumlar
Acibadem Kocaeli Hospital
Izmir Turkey
Centennial Medical Center
Nashville United States
Cleveland Clinic Foundation
Cleveland United States
Emory Healthcare
Atlanta United States
E.N. Meshalkin National Medical Research Center
Novosibirsk Russian Federation
Henry Ford Hospitals
Detroit United States
Massachusetts General Hospital
Boston United States
Minneapolis Heart Institute
Minneapolis United States
Morristown Medical Center
Nen Jersey United States
Oklahoma Heart Institute
Tulsa United States
Presbyterian Hospital of Dallas
Dallas United States
Selçuk Üniversitesi
Selçuklu Turkey
The Christ Hospital - Cincinnati
Cincinnati United States
University Hospitals Case Medical Center
Cleveland United States
University of Washington School of Medicine
Seattle United States
York Hospital, Pennsylvania
York United States
Metrikler
9
Atıf
29
Yazar
4
Anahtar Kelime