TCT-198 Retrograde Recanalization Of Chronic Total Occlusions In Europe: Procedural And In-Hospital Outcomes From The Multicenter ERCTO Registry

Galassi, Alfredo R.; Sianos, Georgios; Werner, Gerald S.; Escaned, Javier; Marzà, Francesco; Boukhris, Marouane; Tomasello, Salvatore D.; Mario, Carlo Di

doi:10.1016/j.jacc.2014.07.239

Cited by 64 publications

(100 citation statements)

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“…Despite the complex cohort recruited, the incidence of adverse events during long‐term follow up was favourable with a TLR of 4.5%. Previous reports from CTO cohorts report TLR of 6.3–10.7% with second generation DES and 17% with first generation DES .…”

Section: Discussionmentioning

confidence: 88%

One‐year outcomes after successful chronic total occlusion percutaneous coronary intervention: The impact of dissection re‐entry techniques

Wilson

Walsh²,

Bagnall

et al. 2017

Cathet Cardio Intervent

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We aimed to determine clinical outcomes 1 year after successful chronic total occlusion (CTO) PCI and, in particular, whether use of dissection and re-entry strategies affects clinical outcomes. Hybrid approaches have increased the procedural success of CTO percutaneous coronary intervention (PCI) but longer-term outcomes are unknown, particularly in relation to dissection and re-entry techniques. Data were collected for consecutive CTO PCIs performed by hybrid-trained operators from 7 United Kingdom (UK) centres between 2012 and 2014. The primary endpoint (death, myocardial infarction, unplanned target vessel revascularization) was measured at 12 months along with angina status. One-year follow up data were available for 96% of successful cases (n = 805). In total, 85% of patients had a CCS angina class of 2-4 prior to CTO PCI. Final successful procedural strategy was antegrade wire escalation 48%; antegrade dissection and re-entry (ADR) 21%; retrograde wire escalation 5%; retrograde dissection and re-entry (RDR) 26%. Overall, 47% of CTOs were recanalized using dissection and re-entry strategies. During a mean follow up of 11.5 ± 3.8 months, the primary endpoint occurred in 8.6% (n = 69) of patients (10.3% (n = 39/375) in DART group and 7.0% (n = 30/430) in wire-based cases). The majority of patients (88%) had no or minimal angina (CCS class 0 or 1). ADR and RDR were used more frequently in more complex cases with greater disease burden, however, the only independent predictor of the primary endpoint was lesion length. CTO PCI in complex lesions using the hybrid approach is safe, effective and has a low one-year adverse event rate. The method used to recanalize arteries was not associated with adverse outcomes. © 2017 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 88%

One‐year outcomes after successful chronic total occlusion percutaneous coronary intervention: The impact of dissection re‐entry techniques

Wilson

Walsh²,

Bagnall

et al. 2017

Cathet Cardio Intervent

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“…Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) is a well‐accepted revascularization procedure . The development of techniques and devices has improved the initial success rate of CTO‐PCI . Recently, the adaptation of algorithms based on angiographical classifications promotes the standardization of strategies in CTO‐PCI procedures .…”

Section: Introductionmentioning

confidence: 99%

Assessment of reattempted percutaneous coronary intervention strategy for chronic total occlusion after prior failed procedures: Analysis of the Japanese CTO‐PCI Expert Registry

Sekiguchi

Muramatsu

Kishi

et al. 2019

Cathet Cardio Intervent

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Objectives We aimed to investigate strategies for reattempted percutaneous coronary interventions (PCIs) for chronic total occlusions (CTOs) by highly skilled operators after a failed attempt. Background Development of complex techniques and algorithms has been standardized for CTO‐PCI. However, there is no appropriate strategy for CTO‐PCI after a failed procedure. Method From 2014 to 2016, the Japanese CTO‐PCI Expert Registry included 4,053 consecutive CTO‐PCIs (mean age: 66.8 ± 10.9 years; male: 85.6%; Japanese CTO [J‐CTO] score: 1.92 ± 1.15). Initial outcomes and strategies for reattempted CTO‐PCIs were evaluated and compared with first‐attempt CTO‐PCIs. Results Reattempt CTO‐PCIs were performed in 820 (20.2%) lesions. The mean J‐CTO score of reattempt CTO‐PCIs was higher than that of first‐attempt CTO‐PCIs (2.86 ± 1.03 vs. 1.68 ± 1.05, p < .001). The technical success rate of reattempt CTO‐PCIs was lower than that of first‐attempt CTO‐PCIs (86.7% vs. 90.8%, p < .001). Regarding successful CTO‐PCIs, the strategies comprised antegrade alone (reattempt: 36.1%, first attempt: 63.8%), bidirectional approach (reattempt: 54.4%, first attempt: 30.3%), and antegrade approach following a failed bidirectional approach (reattempt: 9.4%, first attempt: 5.4%). Parallel wire technique, intravascular ultrasound guide crossing, and bidirectional approach technique were frequently performed in reattempt CTO‐PCIs. Reattempt CTO‐PCIs showed higher rates of myocardial infarction (2.1% vs. 0.9%, p < .001) and coronary perforation (6.9% vs. 4.2%, p = .002) than first‐attempt CTO‐PCIs. Conclusions The technical success rate of reattempt CTO‐PCIs is lower than that of first‐attempt CTO‐PCIs. However, using more complex strategies, the success rate of reattempt CTO‐PCI can be improved by highly skilled operators.

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“…There are two types of CCs: Septal and epicardial CCs. Compared with the classic septal CCs, epicardial CCs CTO PCI attempt rates remain low . Epicardial CCs being longer and more tortuous might be linked with a higher rate of procedural ischemia and tamponade following trauma .…”

Section: Introductionmentioning

confidence: 96%

Epicardial collateral channel for retrograded recanalization of chronic total occlusion percutaneous coronary intervention: Predictors of failure and procedural outcome

Huang

Zhou

et al. 2017

J Interven Cardiology

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TCT-198 Retrograde Recanalization Of Chronic Total Occlusions In Europe: Procedural And In-Hospital Outcomes From The Multicenter ERCTO Registry

Cited by 64 publications

References 0 publications

One‐year outcomes after successful chronic total occlusion percutaneous coronary intervention: The impact of dissection re‐entry techniques

One‐year outcomes after successful chronic total occlusion percutaneous coronary intervention: The impact of dissection re‐entry techniques

Assessment of reattempted percutaneous coronary intervention strategy for chronic total occlusion after prior failed procedures: Analysis of the Japanese CTO‐PCI Expert Registry

Epicardial collateral channel for retrograded recanalization of chronic total occlusion percutaneous coronary intervention: Predictors of failure and procedural outcome

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