Retrograde chronic total occlusion percutaneous coronary intervention using single catheter: A single centre registry

Abstract

Objectives To analyse the feasibility, safety and procedural outcomes of percutaneous coronary intervention (PCI) for chronic total occlusions (CTO) through retrograde approach using single catheter. Methods Our study was a retrospective observational study that enrolled patients who underwent retrograde CTO PCI using a single catheter between June 2016 and February 2020. Clinical success was defined as successful completion of CTO PCI without associated in-hospital major clinical complications like death, myocardial infarction, stroke or urgent revascularisation. Technical success was defined as successful completion of CTO PCI using single catheter and minimum diameter stenosis of <30% with thrombolysis in myocardial infarction (TIMI) flow grade 3, without significant side branch occlusion, flow-limiting dissection, distal embolization, or angiographic thrombus. Results Totally 102 patients underwent retrograde CTO PCI during the study period. Out of which, 15 cases were attempted using single catheter. Mean age of the population was 59.1 ± 8.9 years (males: 86.7%) and the left ventricular ejection fraction (LVEF) was (61% ± 9.1%). Mean number of diseased arteries was 2.1 ± 0.7, length of the CTO was 25.5 ± 7.4 mm and J-CTO score was 2.3 ± 0.7. We achieved a technical success rate of 73.3% using single catheter, and the overall clinical success (Including single catheter and ping pong) was obtained in 86.7% cases. One patient (6.7%) developed cardiac tamponade and none of study population required dialysis for contrast induced acute kidney injury (CI-AKI) Conclusions Retrograde CTO PCI using single catheter is a technically challenging procedure when compared with other CTO PCI. Our study demonstrated acceptable outcomes which is comparable to other antegrade and retrograde CTO PCI registries.

An Overview of Contrast-induced Acute Kidney Injury

“…The prevalence of CI-AKI in India has been summarized in Table 2 for the convenience of the readers. [18][19][20][21][22][23][24][25][26][27][28][29][30][31] Indians have the highest rates of coronary artery disease (CAD) incidence, 23 and percutaneous coronary intervention (PCI) is thus a lifesaving option for many CAD patients in India and shows a crucial role in interventional cardiology. 24 According to the National Interventional Council of the Cardiological Society of India, approximately 4,38,351 PCIs are performed each year in India, and this number is on the rise.…”

“…The prevalence of CI-AKI in India has been summarized in Table 2 for the convenience of the readers. 18–31…”

“…Comorbidity is highly prevalent among patients undergoing PCI. [18][19][20][21][22][23][24][25][26][27][28][29][30][31]…”