Retrograde chronic total occlusion percutaneous coronary intervention via ipsilateral collaterals.

chronic total occlusion ipsilateral collaterals percutaneous coronary intervention retrograde approach

Journal

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions

ISSN: 1522-726X

Titre abrégé: Catheter Cardiovasc Interv

Pays: United States

ID NLM: 100884139

Informations de publication

Date de publication:
02 Apr 2024

Historique:

revised: 22 02 2024

received: 08 11 2023

accepted: 19 03 2024

medline: 2 4 2024

pubmed: 2 4 2024

entrez: 2 4 2024

Statut: aheadofprint

Résumé

There is limited data on retrograde chronic total occlusion (CTO) percutaneous coronary intervention (PCI) via ipsilateral epicardial collaterals (IEC). To compare the clinical and angiographic characteristics, and outcomes of retrograde CTO PCI via IEC versus other collaterals in a large multicenter registry. Observational cohort study from the Prospective Global registry for the study of Chronic Total Occlusion Intervention (PROGRESS-CTO). Of 4466 retrograde cases performed between 2012 and 2023, crossing through IEC was attempted in 191 (4.3%) cases with 50% wiring success. The most common target vessel in the IEC group was the left circumflex (50%), in comparison to other retrograde cases, where the right coronary artery was most common (70%). The Japanese CTO score was similar between the two groups (3.13 ± 1.23 vs. 3.06 ± 1.06, p = 0.456); however, the IEC group had a higher Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS-CTO) score (1.95 ± 1.02 vs. 1.27 ± 0.92, p < 0.0001). The most used IEC guidewire was the SUOH 03 (39%), and the most frequently used microcatheter was the Caravel (43%). Dual injection was less common in IEC cases (66% vs. 89%, p < 0.0001). Technical (76% vs. 79%, p = 0.317) and procedural success rates (74% vs. 79%, p = 0.281) were not different between the two groups. However, IEC cases had a higher procedural complications rate (25.8% vs. 16.4%, p = 0.0008), including perforations (17.3% vs. 9.0%, p = 0.0001), pericardiocentesis (3.1% vs. 1.2%, p = 0.018), and dissection/thrombus of the donor vessel (3.7% vs. 1.2%, p = 0.002). The use of IEC for retrograde CTO PCI was associated with similar technical and procedural success rates when compared with other retrograde cases, but higher incidence of periprocedural complications.

Sections du résumé

BACKGROUND BACKGROUND

There is limited data on retrograde chronic total occlusion (CTO) percutaneous coronary intervention (PCI) via ipsilateral epicardial collaterals (IEC).

AIMS OBJECTIVE

To compare the clinical and angiographic characteristics, and outcomes of retrograde CTO PCI via IEC versus other collaterals in a large multicenter registry.

METHODS METHODS

Observational cohort study from the Prospective Global registry for the study of Chronic Total Occlusion Intervention (PROGRESS-CTO).

RESULTS RESULTS

Of 4466 retrograde cases performed between 2012 and 2023, crossing through IEC was attempted in 191 (4.3%) cases with 50% wiring success. The most common target vessel in the IEC group was the left circumflex (50%), in comparison to other retrograde cases, where the right coronary artery was most common (70%). The Japanese CTO score was similar between the two groups (3.13 ± 1.23 vs. 3.06 ± 1.06, p = 0.456); however, the IEC group had a higher Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS-CTO) score (1.95 ± 1.02 vs. 1.27 ± 0.92, p < 0.0001). The most used IEC guidewire was the SUOH 03 (39%), and the most frequently used microcatheter was the Caravel (43%). Dual injection was less common in IEC cases (66% vs. 89%, p < 0.0001). Technical (76% vs. 79%, p = 0.317) and procedural success rates (74% vs. 79%, p = 0.281) were not different between the two groups. However, IEC cases had a higher procedural complications rate (25.8% vs. 16.4%, p = 0.0008), including perforations (17.3% vs. 9.0%, p = 0.0001), pericardiocentesis (3.1% vs. 1.2%, p = 0.018), and dissection/thrombus of the donor vessel (3.7% vs. 1.2%, p = 0.002).

CONCLUSION CONCLUSIONS

The use of IEC for retrograde CTO PCI was associated with similar technical and procedural success rates when compared with other retrograde cases, but higher incidence of periprocedural complications.

Identifiants

DOI: 10.1002/ccd.31019 PMID: 38563074

pubmed: 38563074

doi: 10.1002/ccd.31019

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Informations de copyright

Références

Kahn JK, Hartzler GO. Retrograde coronary angioplasty of isolated arterial segments through saphenous vein bypass grafts. Cathet Cardiovasc Diagn. 1990;20(2):88‐93.

Karmpaliotis D, Karatasakis A, Alaswad K, et al. Outcomes with the use of the retrograde approach for coronary chronic total occlusion interventions in a contemporary multicenter US registry. Circ Cardiovasc Interv. 2016;9(6):e003434.

Megaly M, Xenogiannis I, Abi Rafeh N, et al. Retrograde approach to chronic total occlusion percutaneous coronary intervention. Circ Cardiovasc Interv. 2020;13(5):e008900.

Allana S, Kostantinis S, Rempakos A, et al. TCT‐334 technical analysis and procedural outcomes of retrograde approach to chronic total occlusion percutaneous coronary interventions: insights from an international multicenter registry. J Am Coll Cardiol. 2023;82(17 suppl):B133‐B134.

Sianos G, Barlis P, Di Mario C, et al. European experience with the retrograde approach for the recanalisation of coronary artery chronic total occlusions. A report on behalf of the euroCTO club. EuroIntervention. 2008;4(1):84‐92.

McEntegart MB, Badar AA, Ahmad FA, et al. The collateral circulation of coronary chronic total occlusions. EuroIntervention. 2016;11(14):e1596‐e1603.

Mashayekhi K, Behnes M, Akin I, Kaiser T, Neuser H. Novel retrograde approach for percutaneous treatment of chronic total occlusions of the right coronary artery using ipsilateral collateral connections: a European centre experience. EuroIntervention. 2016;11(11):e1231‐e1236.

Mashayekhi K, Behnes M, Valuckiene Z, et al. Comparison of the ipsi‐lateral versus contra‐lateral retrograde approach of percutaneous coronary interventions in chronic total occlusions. Catheter Cardiovasc Interv. 2017;89(4):649‐655.

Harris PA, Taylor R, Minor BL, et al. The REDCap consortium: building an international community of software platform partners. J Biomed Inf. 2019;95:103208.

Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)—a metadata‐driven methodology and workflow process for providing translational research informatics support. J Biomed Inf. 2009;42(2):377‐381.

Thygesen K, Alpert JS, Jaffe AS, et al. Third universal definition of myocardial infarction. Circulation. 2012;126(16):2020‐2035.

Morino Y, Abe M, Morimoto T, et al. Predicting successful guidewire crossing through chronic total occlusion of native coronary lesions within 30 minutes. JACC Cardiovasc Interv. 2011;4(2):213‐221.

Christopoulos G, Kandzari DE, Yeh RW, et al. Development and validation of a novel scoring system for predicting technical success of chronic total occlusion percutaneous coronary interventions. JACC Cardiovasc Interv. 2016;9(1):1‐9.

Simsek B, Kostantinis S, Karacsonyi J, et al. Predicting periprocedural complications in chronic total occlusion percutaneous coronary intervention. JACC Cardiovasc Interv. 2022;15(14):1413‐1422.

Azzalini L, Agostoni P, Benincasa S, et al. Retrograde chronic total occlusion percutaneous coronary intervention through ipsilateral collateral channels. JACC Cardiovasc Interv. 2017;10(15):1489‐1497.

Gasparini GL, Bollati M, Chiarito M, et al. SUOH 03 guidewire for the management of coronary artery dissection: insights from a multicenter registry. J Interv Cardiol. 2023;2023:1‐7.

Brilakis ES, Grantham JA, Banerjee S. “Ping‐pong” guide catheter technique for retrograde intervention of a chronic total occlusion through an ipsilateral collateral. Catheter Cardiovasc Interv. 2011;78(3):395‐399.

Azzalini L, Poletti E, Ayoub M, et al. Coronary artery perforation during chronic total occlusion percutaneous coronary intervention: epidemiology, mechanisms, management, and outcomes. EuroIntervention. 2019;15(9):e804‐e811.

Hirai T, Nicholson WJ, Sapontis J, et al. A detailed analysis of perforations during chronic total occlusion angioplasty. JACC Cardiovasc Interv. 2019;12(19):1902‐1912.

Ribeiro MH, Campos CM, Padilla L, et al. Risk burden of coronary perforation in chronic total occlusion recanalization: Latin American CTO registry analysis. J Am Heart Assoc. 2022;11(11):e024815.