Use of antegrade dissection re-entry in coronary chronic total occlusion percutaneous coronary intervention in a contemporary multicenter registry
Danek BA, Karatasakis A, Karmpaliotis D, Alaswad K, Yeh RW, Jaffer FA, Patel M, Bahadorani J, Lombardi WL, Wyman MR, Grantham JA, Doing A, Moses JW, Kirtane A, Parikh M, Ali ZA, Kalra S, Kandzari DE, Lembo N, Garcia S, Rangan BV, Thompson CA, Banerjee S, Brilakis ES. Use of antegrade dissection re-entry in coronary chronic total occlusion percutaneous coronary intervention in a contemporary multicenter registry. Int J Cardiol. Jul 1 2016;214:428-437.
International journal of cardiology
BACKGROUND: We assessed efficacy and safety of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) using antegrade dissection re-entry (ADR).
METHODS: We examined outcomes of ADR among 1313 CTO PCIs performed at 11 US centers between 2012-2015.
RESULTS: 84.1% of patients were men. Prevalence of prior coronary artery bypass graft surgery was 34.3%. Overall technical and procedural success were 90.1% and 88.7%, respectively. In-hospital major adverse cardiovascular events (MACE) occurred in 31 patients (2.4%). ADR was used in 458 cases (34.9%), and was the first strategy in 169 cases (12.9%). ADR cases were angiographically more complex than non-ADR cases (mean J-CTO score: 2.8±1.2 vs. 2.4±1.2, p
CONCLUSIONS: ADR is used relatively frequently in contemporary CTO PCI, especially for challenging lesions and after failure of other strategies. ADR is associated with similar success rates and risk for complications as compared with AWE, and is important for achieving high procedural success.
Medical Subject Headings
Aged; Coronary Artery Bypass; Coronary Occlusion; Female; Humans; Male; Middle Aged; Percutaneous Coronary Intervention; Registries; Risk Factors; Treatment Outcome