Primary versus rescue retrograde approach for chronic total coronary occlusion
Objectives We aimed to assess the advantages of using the retrograde approach as an initial strategy rather than as a rescue strategy for complex chronic total occlusions (CTOs). Background Even for complex CTOs where a retrograde approach is deemed necessary, an antegrade approach is frequently use...
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Veröffentlicht in: | Catheterization and cardiovascular interventions 2022-02, Vol.99 (2), p.219-225 |
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Hauptverfasser: | , , , , , , , , , |
Format: | Artikel |
Sprache: | eng |
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Zusammenfassung: | Objectives
We aimed to assess the advantages of using the retrograde approach as an initial strategy rather than as a rescue strategy for complex chronic total occlusions (CTOs).
Background
Even for complex CTOs where a retrograde approach is deemed necessary, an antegrade approach is frequently used as an initial strategy in real‐world practice.
Methods
We evaluated 352 retrograde procedures for CTO conducted at our high‐volume center between January 2007 and January 2019. Procedural efficiency and safety was assessed based on the guidewire manipulation time (GWMT) and the occurrence of procedure‐related adverse events for the primary retrograde approach (PRA) and the rescue retrograde approach (RRA).
Results
PRA and RRA were used in 191 (54.3%) and 161 (45.7%) of the CTO procedures, respectively. The complexity of the CTO lesion was significantly higher in the PRA group than in the RRA group (Japanese‐CTO score, 2.62 ± 1.07 vs. 2.38 ± 1.06, p = 0.037). The technical success rate of two groups was similar (p = 0.47). The median GWMT required for PRA was significantly shorter than that for RRA (85 [interquartile range, 55–126] vs. 120 [85–157] min, p |
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ISSN: | 1522-1946 1522-726X |
DOI: | 10.1002/ccd.30023 |