Temporal Trends in Retrograde Crossing of Epicardial Collaterals in Chronic Total Occlusion Percutaneous Coronary Intervention
Simsek B, Kostantinis S, Karacsonyi J, Basir MB, Megaly M, Masoumi A, Jaffer FA, Gorgulu S, Brilakis ES, and Alaswad K. Temporal Trends in Retrograde Crossing of Epicardial Collaterals in Chronic Total Occlusion Percutaneous Coronary Intervention. J Invasive Cardiol 2022.
The Journal of invasive cardiology
BACKGROUND: The use of retrograde crossings in chronic total occlusion (CTO) percutaneous coronary intervention (PCI) provides higher technical success rates in CTO-PCI. However, the use of epicardial collaterals carries a higher complication risk.
METHODS AND RESULTS: In this study, we aimed to investigate the temporal trends in retrograde crossing of epicardial collaterals, introduction of new guidewires, in-hospital major adverse cardiovascular events (MACE), and technical success rates in a large, multinational registry. We demonstrate that technical success rates increased substantially from about 5%-10% to 76% in the past decade without a concomitant increase in MACE rate (~3% to 4%), likely associated with increased operator experience and introduction of new guidewires. In addition, we show that while high-volume centers have higher technical success, they also have higher perforation rates.
Medical Subject Headings
Chronic Disease; Coronary Angiography; Coronary Occlusion; Humans; Percutaneous Coronary Intervention; Registries; Risk Factors; Treatment Outcome
ePub ahead of print