Procedural and In-hospital Outcomes of Rotational Atherectomy in Retrograde Coronary Chronic Total Occlusion Intervention. (January 2021)

• Record Type: Journal Article
• Authors: Xu, Rende; Song, Xiaoyue; Chang, Shufu; Qin, Qing; Li, Chenguang; Fu, Mingqiang; Ren, Daoyuan; Ge, Lei; Qian, Juying; Ma, Jianying; Ge, Junbo
• Is Part Of: Angiology. Volume 72:Number 1(2021)
• Page Start: 44
• Page End: 49
• Publication Date: 2021-01
• Subjects: coronary chronic total occlusion -- rotational atherectomy -- retrograde PCI; Blood-vessels -- Diseases -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; 616.13005
• DOI: 10.1177/0003319720949312
• Languages: English
• ISSNs: 0003-3197

Abstract

Coronary chronic total occlusions (CTOs) are characterized by a high incidence of severe plaque calcifications, which are associated with a high use of the retrograde approach and a low success rate of percutaneous coronary intervention (PCI). However, the feasibility of rotational atherectomy (RA) in retrograde CTO-PCI remains unknown. The aim of the present study is to examine the safety and efficacy of RA in retrograde CTO-PCI. Consecutive patients (n = 129) who underwent RA during CTO-PCI were categorized into anterograde and retrograde groups according to the CTO crossing approach. The distributions of the baseline characteristics were similar in the 2 groups, but the lesion type was more complex ( P = .001), and the starting burr size was smaller ( P = .003) in the retrograde group than in the anterograde group. There was a trend of a higher incidence of procedural complications in the retrograde group than in the anterograde group ( P = .054). Technical and procedural success and in-hospital outcomes were not significantly different between the 2 groups. In conclusion, RA was feasible in retrograde CTO PCI, but some specific precautions are required before and during the procedure. In addition, further investigation of the long-term outcomes of RA in retrograde CTO PCI is necessary.