Retrograde Chronic Total Occlusion Percutaneous Coronary Interventions: Predictors of Procedural Success From the ERCTO Registry.
JACC Cardiovasc Interv
; 15(8): 834-842, 2022 04 25.
Article
em En
| MEDLINE
| ID: mdl-35450685
ABSTRACT
OBJECTIVES:
The aim of this study was to identify independent predictors of procedural success after retrograde chronic total occlusion (CTO) percutaneous coronary intervention (PCI).BACKGROUND:
Retrograde CTO PCI is an established technique, but predictors of success remain poorly understood.METHODS:
A multivariable logistic regression model was used to analyze potentially important demographic, clinical, anatomical, and technical aspects of retrograde CTO PCI cases uploaded to the multicenter European CTO (ERCTO) Club Registry.RESULTS:
In calendar years 2018 and 2019, 2,364 retrograde CTO PCI cases constituted the primary analysis cohort. A primary retrograde strategy was used in 1,953 cases (82.6%), and an initial antegrade approach was converted to retrograde in 411 cases (17.4%). Procedural success was achieved in 1,820 cases (77.0%) and was more likely to occur after a primary retrograde attempt versus conversion from an initial antegrade approach (80.9% vs 58.4%; P < 0.0001). After multivariable analysis, an absence of lesion calcification (OR 1.86; 95% CI 1.37-2.51; P < 0.0001), a higher degree of distal vessel opacification (OR 2.47; 95% CI 1.72-3.55; P < 0.0001), little or no proximal target vessel tortuosity (OR 1.84; 95% CI 1.28-2.64; P = 0.001), Werner collateral connection CC1 (OR 4.87; 95% CI 2.90-8.19; P < 0.0001) or CC2 (OR 5.33; 95% CI 3.02-9.42; P < 0.0001), and the top tertile of operator volume (>120 cases over 2 years) (OR 1.88; 95% CI 1.26-2.79; P = 0.002) were associated with the greatest chance of achieving angiographic success.CONCLUSIONS:
Less calcification with good distal vessel opacification, little or absent proximal vessel tortuosity, and visible collateral connections, along with high-volume operator status, were all independently predictive of angiographically successful retrograde CTO PCI.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Oclusão Coronária
/
Intervenção Coronária Percutânea
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
JACC Cardiovasc Interv
Assunto da revista:
ANGIOLOGIA
/
CARDIOLOGIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Reino Unido