Angiographic success and procedural complications in patients undergoing retrograde percutaneous coronary chronic total occlusion interventions: A weighted meta-analysis of 3482 patients from 26 studies

Sabbagh, Abdallah El; Patel, Vishal; Jeroudi, Omar M.; Michael, Tesfaldet T.; Alomar, Mohammed; Mogabgab, Owen; Fuh, Eric; Roesle, Michele; Rangan, Bavana V.; Abdullah, Shuaib; Hastings, Jeffrey L.; Grodin, Jerrold; Kumbhani, Dharam J.; Alexopoulos, Dimitrios; Fasseas, Panayotis; Banerjee, Subhash; Brilakis, Emmanouil S.

doi:10.1016/j.ijcard.2014.04.004

Cited by 92 publications

(46 citation statements)

References 39 publications

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“…In recent years, owing to major developments in PCI techniques, significant improvement in outcomes of recanalization procedures has been observed. In experienced centres the reported success rate is close to 90% [13,14]. Multiple studies support the benefit of opening a CTO with regard to symptom relief [15].…”

Section: Discussionmentioning

confidence: 87%

Impact of the presence of chronically occluded coronary artery on long-term prognosis of patients with acute ST-segment elevation myocardial infarction

et al. 2017

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Background: Multivessel disease (MVD) is a significant risk factor in patients with acute ST-segment elevation myocardial infarction (STEMI (OR 2.07, p = 0.002), whereas triple vessel disease was not (OR 1.27, p = 0.358). The other independent predictors of mortality were: age, anterior myocardial infarction, and PCI failure. Conclusions:The presence of CTO is an independent predictor of the long-term mortality in STEMI patients treated with primary PCI. (Cardiol J 2017; 24, 2: 117-124)

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Section: Discussionmentioning

confidence: 87%

Impact of the presence of chronically occluded coronary artery on long-term prognosis of patients with acute ST-segment elevation myocardial infarction

et al. 2017

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“…The retrograde approach has been shown to improve procedural success rates, but may also carry increased risk for complications, 5, 24 can be more labor intensive, and may require longer time and specialized equipment and training. 25, 26 Pre-procedure calculation of the J-CTO score may encourage the operator to switch earlier to a retrograde approach.…”

Section: Discussionmentioning

confidence: 99%

Clinical Utility of the Japan–Chronic Total Occlusion Score in Coronary Chronic Total Occlusion Interventions

Christopoulos

Wyman

Alaswad

et al. 2015

Circ: Cardiovascular Interventions

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103

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Background The performance of the J-CTO score in predicting success and efficiency of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. Methods and Results We examined the records of 650 consecutive patients who underwent CTO PCI between 2011 and 2014 at six experienced centers in the United States. Six hundred and fifty-seven lesions were classified as easy (J-CTO=0), intermediate (J-CTO=1), difficult (J-CTO=2), and very difficult (J-CTO≥3). The impact of the J-CTO score on technical success and procedure time was evaluated with univariable logistic and linear regression, respectively. The performance of the logistic regression model was assessed with the Hosmer-Lemeshow statistic and receiver operator characteristic curves. Antegrade wiring techniques were used more frequently in easy lesions (97%) than very difficult lesions (58%), whereas the retrograde approach became less frequent with increased lesion difficulty (41% for very difficult lesions vs. 13% for easy lesions). The logistic regression model for technical success demonstrated satisfactory calibration and discrimination (p for Hosmer-Lemeshow=0.743 and area under curve=0.705). The J-CTO score was associated with a two-fold increase in the odds of technical failure (odds ratio 2.04, 95% confidence interval [95% CI] 1.52-2.80, p<0.001). Procedure time increased by approximately 20 minutes for every one-point increase of the J-CTO score (regression coefficient 22.33, 95% CI 17.45-27.22, p<0.001). Conclusions J-CTO score was strongly associated with final success and efficiency in this study, supporting its expanded use in CTO interventions. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT02061436.

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“…Complications that can occur in engineering retrograde include perforation of collateral, perforation coronary dissection of blood vessels donor, complications of vascular access, tamponade, nefropathy contrast, myocardial infarction, stroke, wire broken, the tool is stuck (device entrapment) (Sabbagh 2014, Kimura 2012. Security procedures with manipulation wire careful and proper management of complications is needed in retrograde technique.…”

Section: Complications In Retrograde Techniquementioning

confidence: 99%

Case Report: RETROGRADE APPROACH FOR CTO LESIONS: SERIAL CASE

Oktaviono¹

2017

FMI

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ABSTRAK ABSTRACT Chronic total occlusion recanalization still represents the final frontier in percutaneous coronary intervention. Successful revascularization is associated with improved long-term survival, reduced symptoms, improved left ventricular function and reduced need for coronary bypass surgery. Retrograde chronic total occlusion recanalization has recently become an essential complement to the classic antegrade approach. Retrograde approach through the collateral channel has been recently proposed and has the potential to improve the success rate of percutaneous coronary intervention (PCI) in chronic total occlusion (CTO) lesion

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Angiographic success and procedural complications in patients undergoing retrograde percutaneous coronary chronic total occlusion interventions: A weighted meta-analysis of 3482 patients from 26 studies

Cited by 92 publications

References 39 publications

Impact of the presence of chronically occluded coronary artery on long-term prognosis of patients with acute ST-segment elevation myocardial infarction

Impact of the presence of chronically occluded coronary artery on long-term prognosis of patients with acute ST-segment elevation myocardial infarction

Clinical Utility of the Japan–Chronic Total Occlusion Score in Coronary Chronic Total Occlusion Interventions

Case Report: RETROGRADE APPROACH FOR CTO LESIONS: SERIAL CASE

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