Retrograde Recanalization of Chronic Total Occlusions in Europe

Galassi, Alfredo R.; Sianos, Georgios; Werner, Gerald S.; Escaned, Javier; Tomasello, Salvatore D.; Boukhris, Marouane; Castaing, Marine; Büttner, Joachim; Bufe, Alexander; Kalniņš, Artis; Spratt, James C.; Garbo, Roberto; Hildick‐Smith, David; Elhadad, Simon; Gagnor, Andrea; Lauer, Bernward; Bryniarski, Leszek; Christiansen, Evald Høj; Thuesen, Leif; Meyer‐Geßner, Markus; Göktekín, Ömer; Carlino, Mauro; Louvard, Yves; Lefèvre, Thierry; Lismanis, Aigars; Gelev, Valery; Serra, Antonio; Marzà, Francesco; Mario, Carlo Di; Reifart, Nicolaus

doi:10.1016/j.jacc.2015.03.566

Cited by 216 publications

(59 citation statements)

References 30 publications

(7 reference statements)

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“…We also found that selected SVGs, either patent or occluded, can become very effective conduits for retrograde CTO PCI, and their use is associated with a very high final technical success and low complication. When we compared our single center CTO program data to those from Europe, Japan, and the USA [10][11][12]19,20 (Table 8), we found that our study population had one of the highest number of post-CABG CTO cases, comparable only to 1 American multicenter study of 2013 by Michael et al 20 We used a retrograde approach in post-CABG patients more frequently than anyone else. In the same post-CABG cohort, we performed retrograde CTO PCI via SVG more often than others.…”

Section: Discussionmentioning

confidence: 74%

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Recanalization of Chronic Total Occlusions in Patients With Previous Coronary Bypass Surgery and Consideration of Retrograde Access via Saphenous Vein Grafts

Dautov

Nguyen

Altisent

et al. 2016

Circ: Cardiovascular Interventions

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Background-The prevalence of native coronary chronic total occlusions (CTOs) after coronary artery bypass grafts (CABGs) is higher than in non-CABG population. We examined outcomes of CTO percutaneous coronary intervention (PCI) post-CABG versus without CABG. Then, we looked at feasibility and outcomes of retrograde CTO PCI via patent or occluded saphenous vein graft. Methods and Results-We compared patient and procedural characteristics of 470 CTO cases treated from January 2010 to December 2015 depending on history of CABG. We assessed major adverse cardiac events, including cardiac death, myocardial infarction, ischemia-driven target-vessel revascularization, or reocclusion 1 year after successful CTO PCI in patients treated before February 2015. Post-CABG patients (175 cases) had a higher J-CTO score (2.5 versus 2.1; P=0.002). In-hospital complications were similar, although the incidence of contrast-induced nephropathy was higher in post-CABG patients (4.6% versus 1%; P=0.01). With multivariable analysis, post-CABG status was associated with higher incidence of 1-year major adverse cardiac event (hazards ratio=2.2; P=0.02). As a second level analysis, we looked at the feasibility and safety of CTO PCI via saphenous vein grafts (19% of post-CABG cases) versus collateral channels (36%) versus with an antegrade-only approach (45%), and assessed short-term outcomes and complications. High success was achieved in the saphenous vein graft group. In-hospital events were similar in the 3 groups. Conclusions-Post-CABG CTO PCI is associated with similar high success and low complications compared with CTO PCI in patients who never had CABG. However, it is associated with higher recurrent events at 1 year. To achieve high success rate, use of saphenous vein grafts as retrograde conduits seems to be safe and effective. (Circ Cardiovasc Interv. 2016;9:e003515.

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Section: Discussionmentioning

confidence: 74%

“…Histologically, native coronary CTO lesions of patients post-CABG are more extensively calcified 9 and therefore offer additional challenges that may also affect long-term outcomes. Only few studies have evaluated outcomes following CTO PCI in post-CABG patients, [10][11][12] and none reported longer-term outcomes.…”

mentioning

confidence: 99%

Recanalization of Chronic Total Occlusions in Patients With Previous Coronary Bypass Surgery and Consideration of Retrograde Access via Saphenous Vein Grafts

Dautov

Nguyen

Altisent

et al. 2016

Circ: Cardiovascular Interventions

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“…According to the data from this register, during the period from year 2008 to 2012, a retrograde method was used in 16.5% of successful procedures and the success rate reached 75% (Gallassi et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Chronic Total Coronary Artery Occlusion Recanalisation with Percutaneous Coronary Intervention — Single Centre 10-Year Experience

Kalniņš

Strēle

Kurcalte

et al. 2018

Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences.

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“…However, the retrograde approach carries higher risk for procedure‐related complications. Results of the largest retrograde CTO PCI registries (>300 cases) published to date are summarized in Table 4 74, 75, 76, 77, 78. Careful selection of collateral channels is essential for optimizing the success and safety of the retrograde approach.…”

Section: Retrograde Approachmentioning

confidence: 99%

Chronic Total Occlusion Percutaneous Coronary Intervention: Evidence and Controversies

Tajti

Brilakis

2018

JAHA

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Retrograde Recanalization of Chronic Total Occlusions in Europe

Abstract: The number of retrograde procedures in Europe has increased, with high percents of success, low rates of major complications, and good long-term outcomes.

Cited by 216 publications

References 30 publications

Recanalization of Chronic Total Occlusions in Patients With Previous Coronary Bypass Surgery and Consideration of Retrograde Access via Saphenous Vein Grafts

Recanalization of Chronic Total Occlusions in Patients With Previous Coronary Bypass Surgery and Consideration of Retrograde Access via Saphenous Vein Grafts

Chronic Total Coronary Artery Occlusion Recanalisation with Percutaneous Coronary Intervention — Single Centre 10-Year Experience

Chronic Total Occlusion Percutaneous Coronary Intervention: Evidence and Controversies

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