OBJECTIVES: This registry evaluated the current trends and outcomes associated with retrograde percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). BACKGROUND: Since its introduction, several techniques and technologies have been introduced for retrograde PCI for CTO. METHODS: Eight hundred and one patients who underwent retrograde PCI for CTO in 28 Japanese centers between January 2009 and December 2010 were enrolled in this registry. RESULTS: Overall procedural and clinical success rates were 84.8 and 83.8%, respectively, of which, retrograde procedures accounted for 71.2 and 70.3%, respectively. The use of channel dilators increased in 2010 compared to that in 2009 (36 vs. 95.3%, P < 0.0001), attributed improving collateral channel crossing using a wire and catheter (70.6% vs. 81.1%, P = 0.0005) and increased availability of epicardial channels (27.6% vs. 36.9%). The use of the reverse controlled antegrade and retrograde tracking technique also increased (41.9 vs. 66.5%). Although these changes decreased procedure time (203.3 min vs. 187.9 min, P = 0.024), they did not significantly improve overall procedural success rate (84.1% vs. 85.3%, P = 0.63). Multivariate analysis identified age 65 years or more and lesion calcification as unfavorable factors and the use of a channel dilator as a favorable factor for retrograde procedural success. CONCLUSIONS: Increased availability of channel dilators has altered strategies for retrograde PCI for CTO. However, retrograde PCI for CTO could be improved by overcoming its main obstacle of severe calcification.
OBJECTIVES: This registry evaluated the current trends and outcomes associated with retrograde percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). BACKGROUND: Since its introduction, several techniques and technologies have been introduced for retrograde PCI for CTO. METHODS: Eight hundred and one patients who underwent retrograde PCI for CTO in 28 Japanese centers between January 2009 and December 2010 were enrolled in this registry. RESULTS: Overall procedural and clinical success rates were 84.8 and 83.8%, respectively, of which, retrograde procedures accounted for 71.2 and 70.3%, respectively. The use of channel dilators increased in 2010 compared to that in 2009 (36 vs. 95.3%, P < 0.0001), attributed improving collateral channel crossing using a wire and catheter (70.6% vs. 81.1%, P = 0.0005) and increased availability of epicardial channels (27.6% vs. 36.9%). The use of the reverse controlled antegrade and retrograde tracking technique also increased (41.9 vs. 66.5%). Although these changes decreased procedure time (203.3 min vs. 187.9 min, P = 0.024), they did not significantly improve overall procedural success rate (84.1% vs. 85.3%, P = 0.63). Multivariate analysis identified age 65 years or more and lesion calcification as unfavorable factors and the use of a channel dilator as a favorable factor for retrograde procedural success. CONCLUSIONS: Increased availability of channel dilators has altered strategies for retrograde PCI for CTO. However, retrograde PCI for CTO could be improved by overcoming its main obstacle of severe calcification.
Authors: Georgios Christopoulos; Dimitri Karmpaliotis; Khaldoon Alaswad; Robert W Yeh; Farouc A Jaffer; R Michael Wyman; William L Lombardi; Rohan V Menon; J Aaron Grantham; David E Kandzari; Nicholas Lembo; Jeffrey W Moses; Ajay J Kirtane; Manish Parikh; Philip Green; Matthew Finn; Santiago Garcia; Anthony Doing; Mitul Patel; John Bahadorani; Muhammad Nauman J Tarar; Georgios E Christakopoulos; Craig A Thompson; Subhash Banerjee; Emmanouil S Brilakis Journal: Int J Cardiol Date: 2015-06-27 Impact factor: 4.164
Authors: Lei Song; Akiko Maehara; Matthew T Finn; Sanjog Kalra; Jeffrey W Moses; Manish A Parikh; Ajay J Kirtane; Michael B Collins; Tamim M Nazif; Khady N Fall; Raja Hatem; Ming Liao; Tiffany Kim; Philip Green; Ziad A Ali; Candido Batres; Martin B Leon; Gary S Mintz; Dimitri Karmpaliotis Journal: JACC Cardiovasc Interv Date: 2017-05-22 Impact factor: 11.195
Authors: Dimitri Karmpaliotis; Aris Karatasakis; Khaldoon Alaswad; Farouc A Jaffer; Robert W Yeh; R Michael Wyman; William L Lombardi; J Aaron Grantham; David E Kandzari; Nicholas J Lembo; Anthony Doing; Mitul Patel; John N Bahadorani; Jeffrey W Moses; Ajay J Kirtane; Manish Parikh; Ziad A Ali; Sanjog Kalra; Phuong-Khanh J Nguyen-Trong; Barbara A Danek; Judit Karacsonyi; Bavana V Rangan; Michele K Roesle; Craig A Thompson; Subhash Banerjee; Emmanouil S Brilakis Journal: Circ Cardiovasc Interv Date: 2016-06 Impact factor: 6.546