Technical and procedural outcomes of the retrograde approach to chronic total occlusion interventions
Tajti P, Xenogiannis I, Gargoulas F, Karmpaliotis D, Alaswad K, Jaffer FA, Patel MP, Burke MN, Garcia S, Krestyaninov O, Koutouzis M, Jaber W, and Brilakis ES. Technical and procedural outcomes of the retrograde approach to chronic total occlusion interventions. EuroIntervention 2020; 16(11):e891-e899.
AIMS: The retrograde approach is critical for achieving high success rates in chronic total occlusion (CTO) percutaneous coronary intervention (PCI), but has been associated with higher risk of complications. We examined the contemporary outcomes of the retrograde approach to CTO PCI aiming to identify areas in need of improvement.
METHODS AND RESULTS: We compared the technical and procedural outcomes of retrograde (n=1,515) and antegrade-only CTO PCIs (n=2,686) in a contemporary multicentre CTO registry. The mean age of patients undergoing retrograde PCI was 65±10 years and 86% were men, with high prevalence of prior myocardial infarction (51%), prior PCI (71%), and coronary artery bypass graft surgery (45%). The mean J-CTO score (3±1 vs 2±1, p
CONCLUSIONS: In summary, the retrograde approach to CTO PCI is performed in higher complexity lesions and is associated with lower success rates and a higher rate of major complications.
CLINICAL TRIAL REGISTRATION: NCT02061436, Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS-CTO).
Medical Subject Headings
Aged; Chronic Disease; Coronary Angiography; Coronary Occlusion; Female; Humans; Male; Middle Aged; Percutaneous Coronary Intervention; Prospective Studies; Registries; Risk Factors; Treatment Outcome