TCT-338 “Tip in/Rendez-vous” Technique in Retrograde Chronic Total Occlusion Percutaneous Coronary Interventions: Insights From the PROGRESS CTO Registry
Recommended Citation
Allana S, Kostantinis S, Rempakos A, Simsek B, Karacsonyi J, Alexandrou M, Azzalini L, Alaswad K, Khatri J, Choi J, Jaffer F, Benton S, Davies R, Poommipanit P, Frizzell J, Khelimskii D, Gorgulu S, Krestyaninov O, Chandwaney R, Rinfret S, Jaber W, Jefferson B, Sandoval Y, Rangan B, Brilakis E. TCT-338 “Tip in/Rendez-vous” Technique in Retrograde Chronic Total Occlusion Percutaneous Coronary Interventions: Insights From the PROGRESS CTO Registry. 2023; :B135.
Document Type
Conference Proceeding
Publication Date
10-24-2023
Abstract
Background: After successful retrograde crossing, wire externalization is the default strategy. “Tip-in/rendez-vous” technique is an alternative strategy that is less frequently used. The aim of the study was to assess procedural strategies and outcomes of “tip-in/rendez-vous” technique in retrograde chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Methods: We examined clinical and angiographic characteristics, procedural techniques, and outcomes of 2,456 CTO PCIs with successful retrograde crossing performed at 44 U.S. and non-U.S. centers between 2012 and 2023. In-hospital major adverse cardiac events (MACE) included any of the following in-hospital events: death, myocardial infarction, urgent repeat target-vessel revascularization, tamponade requiring pericardiocentesis or surgery, and stroke. Results: “Tip-in/rendez-vous” technique was performed in 73 (3.0%) cases and retrograde wire externalization in 2,383 (97.0%) cases. Compared with the CTO procedures with wire externalization, procedures requiring “tip-in/rendez-vous” required longer fluoroscopy times (86 [60, 118] minutes vs 74 [54, 99] minutes; P = 0.03], higher air kerma radiation dose (4.1 [2.4, 7.7] Gy vs 2.9 [1.7, 4.8] Gy; P = 0.001), and higher contrast volume (300 [185, 450] mL vs 230 [162, 320] mL; P = 0.002]. There was a trend toward lower technical success rate (94.5% vs 97.8%; P = 0.07) among lesions requiring “tip in/rendez-vous” technique. There were no significant differences in the overall procedural success rate (93.2% vs 94.8%; P = 0.53) and the rate of in-hospital MACE between the 2 groups (4.1% vs 3.4%; P = 0.74). Non-RCA target vessel, good distal landing zone, successful epicardial crossing, and proximal cap ambiguity were independently associated with higher likelihood of using “tip-in/rendez-vous” technique over wire externalization. Conclusion: “Tip-in/rendez-vous” technique is infrequently performed in retrograde CTO PCI. Compared with wire externalization, “tip-in/rendez-vous” technique in retrograde CTO PCI is associated with longer fluoroscopy times, higher air kerma radiation dose, higher contrast volume, and similar rates of technical and procedural success and in-hospital MACE. Categories: CORONARY: Complex and Higher Risk Procedures for Indicated Patients (CHIP)
First Page
B135
