Predictors of successful primary antegrade wiring in chronic total occlusion percutaneous coronary intervention
Recommended Citation
Rempakos A, Alexandrou M, Mutlu D, Choi JW, Poommipanit P, Khatri JJ, Young L, Dattilo P, Sadek Y, Davies R, Gorgulu S, Jaffer FA, Chandwaney R, Jefferson B, Elbarouni B, Azzalini L, Kearney KE, Alaswad K, Basir MB, Krestyaninov O, Khelimskii D, Aygul N, Abi-Rafeh N, Elguindy A, Goktekin O, Rangan BV, Mastrodemos OC, Al-Ogaili A, Sandoval Y, Burke MN, Brilakis ES, and Kalyanasundaram A. Predictors of successful primary antegrade wiring in chronic total occlusion percutaneous coronary intervention. J Invasive Cardiol 2024.
Document Type
Article
Publication Date
6-1-2024
Publication Title
The Journal of invasive cardiology
Abstract
BACKGROUND: Antegrade wiring is the most commonly used chronic total occlusion (CTO) crossing technique.
METHODS: Using data from the PROGRESS CTO registry (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention; Clinicaltrials.gov identifier: NCT02061436), we examined the clinical and angiographic characteristics and procedural outcomes of CTO percutaneous coronary interventions (PCIs) performed using a primary antegrade wiring strategy.
RESULTS: Of the 13 563 CTO PCIs performed at 46 centers between 2012 and 2023, a primary antegrade wiring strategy was used in 11 332 (83.6%). Upon multivariable logistic regression analysis, proximal cap ambiguity (odds ratio [OR]: 0.52; 95% CI, 0.46-0.59), side branch at the proximal cap (OR: 0.85; 95% CI, 0.77-0.95), blunt/no stump (OR: 0.52; 95% CI: 0.47-0.59), increasing lesion length (OR [per 10 mm increase]: 0.79; 95% CI, 0.76-0.81), moderate to severe calcification (OR: 0.73; 95% CI, 0.66-0.81), moderate to severe proximal tortuosity (OR: 0.67; 95% CI, 0.59-0.75), bifurcation at the distal cap (OR: 0.66; 95% CI, 0.59-0.73), left anterior descending artery CTO (OR [vs right coronary artery]: 1.44; 95% CI, 1.28-1.62) and left circumflex CTO (OR [vs right coronary artery]: 1.22; 95% CI, 1.07-1.40), non-in-stent restenosis lesion (OR: 0.56; 95% CI, 0.49-0.65), and good distal landing zone (OR: 1.18; 95% CI, 1.06-1.32) were independently associated with primary antegrade wiring crossing success.
CONCLUSIONS: The use of antegrade wiring as the initial strategy was high (83.6%) in our registry. We identified several parameters associated with primary antegrade wiring success.
Medical Subject Headings
Humans; Coronary Occlusion; Percutaneous Coronary Intervention; Male; Female; Middle Aged; Coronary Angiography; Registries; Aged; Chronic Disease; Coronary Vessels; Treatment Outcome; Prospective Studies; Follow-Up Studies
PubMed ID
38446022
ePublication
ePub ahead of print
Volume
36
Issue
6
