Japanese multicenter registry evaluating the retrograde approach for chronic coronary total occlusion. Issue 5 (30th July 2013)

• Record Type: Journal Article
• Authors: Tsuchikane, Etsuo; Yamane, Masahisa; Mutoh, Makoto; Matsubara, Tetsuo; Fujita, Tsutomu; Nakamura, Shigeru; Muramatsu, Toshiya; Okamura, Atsunori; Igarashi, Yasumi; Oida, Akitsugu
• Is Part Of: Catheterization and cardiovascular interventions. Volume 82:Issue 5(2013:Nov. 01)
• Page Start: E654
• Page End: E661
• Publication Date: 2013-07-30
• Subjects: Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.24823
• Languages: English
• ISSNs: 1522-1946

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ccd24823-sec-0001" sec-type="section"> <title>Objectives</title> <p>This registry evaluated the current trends and outcomes associated with retrograde percutaneous coronary intervention (PCI) for chronic total occlusion (CTO).</p> </sec> <sec id="ccd24823-sec-0002" sec-type="section"> <title>Background</title> <p>Since its introduction, several techniques and technologies have been introduced for retrograde PCI for CTO.</p> </sec> <sec id="ccd24823-sec-0003" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="ccd24823-sec-0004" sec-type="section"> <title>Results</title> <p>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%, <italic>P</italic> < 0.0001), attributed improving collateral channel crossing using a wire and catheter (70.6% vs. 81.1%, <italic>P</italic> = 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, <italic>P</italic> = 0.024), they did not significantly improve overall procedural success rate (84.1% vs. 85.3%, <italic>P</italic> = 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.</p> </sec> <sec id="ccd24823-sec-0005" sec-type="section"> <title>Conclusions</title> <p>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. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>