Comparison Between Traditional and Guide-Catheter Extension Reverse Controlled Antegrade Dissection and Retrograde Tracking: Insights From the PROGRESS-CTO Registry.
Xenogiannis I, Karmpaliotis D, Alaswad K, Jaffer FA, Yeh RW, Patel M, Mahmud E, Choi JW, Nicholas Burke M, Doing AH, Dattilo P, Toma C, Conrad Smith AJ, Uretsky B, Krestyaninov O, Khelimskii D, Holper E, Potluri S, Michael Wyman R, Kandzari DE, Garcia S, Koutouzis M, Tsiafoutis I, Jaber W, Samady H, Moses JW, Lembo NJ, Parikh M, Kirtane AJ, Ali ZA, Doshi D, Tajti P, Rangan BV, Abdullah S, Banerjee S, and Brilakis ES. Comparison between traditional and guide-catheter extension reverse controlled antegrade dissection and retrograde tracking: Insights from the PROGRESS-CTO registry. J Interv Cardiol 2019; 31(1):27-34.
The Journal of invasive cardiology
OBJECTIVES: The most common re-entry technique during retrograde chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is reverse controlled antegrade and retrograde tracking (rCART). The use of guide-catheter extensions can facilitate rCART, but has received limited study.
METHODS: We compared the clinical and procedural characteristics and outcomes of traditional rCART vs guide-catheter extension rCART vs cases in which both techniques were used (combined rCART) in patients with successful retrograde CTO crossing in a contemporary multicenter CTO-PCI registry.
RESULTS: Between 2012 and 2018, rCART was used in 467 of 1336 retrograde CTO-PCI cases. Guide-catheter extension rCART was used in 60/467 cases (13%; use increased from 0% in 2012 to 26% in 2017). The traditional rCART group, guide-catheter extension rCART group, and combined rCART group had similar target lesion J-CTO scores (3.3 ± 1.1 vs 3.2 ± 1.2 vs 3.6 ± 0.8, respectively; P=.28), technical success rates (99% vs 100% vs 96.4%, respectively; P=.36), procedural success rates (93.2% vs 93.8% vs 96.3%, respectively; P=.82), and major in-hospital adverse cardiac event (MACE) rates (6.4% vs 9.4% vs 3.6%, respectively; P=.66). Total procedural time was longer in the combined rCART group (196 min [IQR, 146-256 min] vs 200 min [IQR, 164-293 min] vs 255 min [IQR, 195-280 min], respectively; P
CONCLUSIONS: Guide-catheter extension rCART is increasingly being used for retrograde CTO crossing and is associated with similar success and MACE rates as traditional rCART.
Medical Subject Headings
Aged; Angioplasty, Balloon, Coronary; Cardiac Catheterization; Cardiac Catheters; Chronic Disease; Cohort Studies; Coronary Angiography; Coronary Occlusion; Female; Humans; Internationality; Male; Middle Aged; Patient Safety; Prognosis; Registries; Retrospective Studies; Risk Assessment; Severity of Illness Index; Treatment Outcome