Antegrade Approach versus Retrograde Approach Percutaneous Coronary Intervention for Chronic Total Occlusion: An updated Meta-Analysis.
Curr Probl Cardiol
; : 102832, 2024 Sep 16.
Article
en En
| MEDLINE
| ID: mdl-39293774
ABSTRACT
BACKGROUND:
Retrograde approach has notably improved success rates of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). However, longer procedural time, increase use of fluoroscopy and contrast dye have been reported in retrograde techniques in CTO PCI. We aimed to study in-hospital and long-term outcomes of retrograde approach versus antegrade approach in CTO PCI.METHODS:
We searched PubMed, Scopus, WOS, and Cochrane Central until June, 2023 to include all relevant studies that compared retrograde approach versus antegrade approach in patients with CTO PCI. We synthesized the outcome data using a random-effects model, expressing the effect estimates as odds ratios (OR) or mean difference (MD) with corresponding 95% confidence intervals (CI).RESULTS:
A total of 18 studies comprising 18,830 patients were included in the analysis. Regarding in-hospital outcomes, antegrade approach was associated with lower odds of MACE (OR= 0.34, 95% CI 0.23 to 0.51), all-cause mortality (OR= 0.35, 95% CI 0.19 to 0.64), MI (OR= 0.36, 95% CI 0.25 to 0.53), urgent pericardiocentesis (OR= 0.27, 95% CI 0.16 to 0.46), CIN (OR= 0.46, 95% CI 0.33 to 0.65), procedural complications (OR= 0.52, 95% CI 0.33 to 0.83), target vessel perforation (OR= 0.45, 95% CI 0.32 to 0.64). while antegrade was associated with higher success rates (OR= 1.16, 95% CI 1.1 to 1.22).CONCLUSION:
Compared to antegrade technique, retrograde was associated with higher risk for in-hospital and long-term adverse events, and preferably should be performed in more complex CTO lesions.
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1
Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
Curr Probl Cardiol
Año:
2024
Tipo del documento:
Article
País de afiliación:
Egipto
Pais de publicación:
Países Bajos