Atsunori Okamura1, Masahisa Yamane2, Makoto Muto3, Tetsuo Matsubara4, Yasumi Igarashi5, Shigeru Nakamura6, Toshiya Muramatsu7, Tsutomu Fujita8, Akitsugu Oida9, Etsuo Tsuchikane4. 1. Division of Cardiology, Sakurabashi Watanabe Hospital, Osaka, Japan. 2. Cardiology Department, Saitama Sekishinkai Hospital, Saitama, Japan. 3. Division of Cardiology, Saitama Prefecture Cardiovascular and Respiratory Center, Saitama, Japan. 4. Department of Cardiology, Toyohashi Heart Center, Aichi, Japan. 5. Japan Community Health Care Organization Hokkaido Hospital, Cardiovascular Center, Hokkaido, Japan. 6. Kyoto Katsura Hospital, Cardiovascular Center, Kyoto, Japan. 7. Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Kanagawa, Japan. 8. Division of Cardiology, Sapporo CardioVascular Clinic, Hokkaido, Japan. 9. Department of Cardiology, Takase Clinic, Gunma, Japan.
Abstract
OBJECTIVES: This study was performed to determine the complications occurring during retrograde percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) based on analysis of the multicenter, prospective, nonrandomized Retrograde Summit registry. BACKGROUND: Retrograde PCI for CTO has improved treatment success rates, but several complications related to the retrograde approach have been reported, including collateral channel injury and donor artery injury due to their use as retrograde roots. METHODS: This registry included data from 1,166 patients who underwent retrograde PCI for CTO in 28 Japanese centers between January 2009 and December 2011. RESULTS: Overall procedure success and retrograde procedure success were achieved in 985 (84.5%) and 838 (71.9%) of the 1,166 patients, respectively. In-hospital major adverse cardiac and cerebrovascular events (MACCE) occurred in 18 (1.5%) of the 1,166 patients. With regard to complications related to the retrograde approach, channel injury occurred in 111 (9.5%) of the 1,166 patients, but treatment was required in only 24 (2.1%) patients and subsequent cardiac tamponade occurred in only 4 (0.3%) patients. Donor artery problems occurred in only 10 (0.9%) of the 1,166 patients. In sub-analysis regarding the types of collateral channels, the septal channel was significantly safer than epicardial channel because of the lower frequency of non-Q-wave myocardial infarction (non-QMI) and channel injury requiring treatment. CONCLUSIONS: The MACCE rate during retrograde PCI for CTO determined from the Retrograde Summit registry was low and the frequency of complications related to the retrograde approach was acceptable.
OBJECTIVES: This study was performed to determine the complications occurring during retrograde percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) based on analysis of the multicenter, prospective, nonrandomized Retrograde Summit registry. BACKGROUND: Retrograde PCI for CTO has improved treatment success rates, but several complications related to the retrograde approach have been reported, including collateral channel injury and donorartery injury due to their use as retrograde roots. METHODS: This registry included data from 1,166 patients who underwent retrograde PCI for CTO in 28 Japanese centers between January 2009 and December 2011. RESULTS: Overall procedure success and retrograde procedure success were achieved in 985 (84.5%) and 838 (71.9%) of the 1,166 patients, respectively. In-hospital major adverse cardiac and cerebrovascular events (MACCE) occurred in 18 (1.5%) of the 1,166 patients. With regard to complications related to the retrograde approach, channel injury occurred in 111 (9.5%) of the 1,166 patients, but treatment was required in only 24 (2.1%) patients and subsequent cardiac tamponade occurred in only 4 (0.3%) patients. Donor artery problems occurred in only 10 (0.9%) of the 1,166 patients. In sub-analysis regarding the types of collateral channels, the septal channel was significantly safer than epicardial channel because of the lower frequency of non-Q-wave myocardial infarction (non-QMI) and channel injury requiring treatment. CONCLUSIONS: The MACCE rate during retrograde PCI for CTO determined from the Retrograde Summit registry was low and the frequency of complications related to the retrograde approach was acceptable.
Authors: Judit Karacsonyi; Khaldoon Alaswad; Farouc A Jaffer; Robert W Yeh; Mitul Patel; John Bahadorani; Aris Karatasakis; Barbara A Danek; Anthony Doing; J Aaron Grantham; Dimitri Karmpaliotis; Jeffrey W Moses; Ajay Kirtane; Manish Parikh; Ziad Ali; William L Lombardi; David E Kandzari; Nicholas Lembo; Santiago Garcia; Michael R Wyman; Aya Alame; Phuong-Khanh J Nguyen-Trong; Erica Resendes; Pratik Kalsaria; Bavana V Rangan; Imre Ungi; Craig A Thompson; Subhash Banerjee; Emmanouil S Brilakis Journal: J Am Heart Assoc Date: 2016-08-20 Impact factor: 5.501