Novel proctorship effectively teaches interventionists coronary artery chronic total occlusion lesions

Yamamoto, Masanori; Tsuchikane, Etsuo; Kagase, Ai; Shimura, Tetsuro; Teramoto, Tamio; Kimura, Masashi; Matsuo, Hitoshi; Kawase, Yoshiaki; Suzuki, Yoriyasu; Kano, Seiji; Habara, Maoto; Nasu, Kenya; Kinoshita, Yoshihisa; Terashima, Mitsuyasu; Matsubara, Takehiro; Suzuki, Takahiko

doi:10.1016/j.carrev.2017.10.015

Cited by 7 publications

(2 citation statements)

References 22 publications

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“…It should be emphasized that while the J‐Channel score may facilitate a framework for CC selection, other factors set the stage for switching to a retrograde approach, such as proximal cap ambiguity or a poor distal target 19 . Furthermore, to maximize the likelihood of technical success in retrograde CTO PCI, proctorship has been proven to increase the number of performed retrograde procedures and subsequently raise success rates 26,27 . Together with routine assessment of the CTO lesion through grading systems before undertaking a retrograde approach, proctorship facilitates safe and efficient CTO PCI.…”

Section: Discussionmentioning

confidence: 99%

“…19 Furthermore, to maximize the likelihood of technical success in retrograde CTO PCI, proctorship has been proven to increase the number of performed retrograde procedures and subsequently raise success rates. 26,27 Together with routine assessment of the CTO lesion through grading systems before undertaking a retrograde approach, proctorship facilitates safe and efficient CTO PCI.…”

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confidence: 99%

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Collateral grading systems in retrograde percutaneous coronary intervention of chronic total occlusions

Somsen,

de Winter,

Giunta

et al. 2023

Cathet Cardio Intervent

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BackgroundThe Japanese Channel (J‐Channel) score was introduced to aid in retrograde percutaneous coronary intervention (PCI) of chronic total coronary occlusions (CTOs). The predictive value of the J‐Channel score has not been compared with established collateral grading systems such as the Rentrop classification and Werner grade.AimsTo investigate the predictive value of the J‐Channel score, Rentrop classification and Werner grade for successful collateral channel (CC) guidewire crossing and technical CTO PCI success.MethodsA total of 600 prospectively recruited patients underwent CTO PCI. All grading systems were assessed under dual catheter injection. CC guidewire crossing was considered successful if the guidewire reached the distal segment of the CTO vessel through a retrograde approach. Technical CTO PCI success was defined as thrombolysis in myocardial infarction flow grade 3 and residual stenosis <30%.ResultsOf 600 patients, 257 (43%) underwent CTO PCI through a retrograde approach. Successful CC guidewire crossing was achieved in 208 (81%) patients. The predictive value of the J‐Channel score for CC guidewire crossing (area under curve 0.743) was comparable with the Rentrop classification (0.699, p = 0.094) and superior to the Werner grade (0.663, p = 0.002). Technical CTO PCI success was reported in 232 (90%) patients. The Rentrop classification exhibited a numerically higher discriminatory ability (0.676) compared to the J‐Channel score (0.664) and Werner grade (0.589).ConclusionsThe J‐channel score might aid in strategic collateral channel selection during retrograde CTO PCI. However, the J‐Channel score, Rentrop classification, and Werner grade have limited value in predicting technical CTO PCI success.

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Section: Discussionmentioning

confidence: 99%