scholarly journals TCTAP A-049 Retrograde Approach Is as Effective and Safe as Antegrade Approach in Contemporary Percutaneous Coronary Intervention for Chronic Total Occlusion: A Single-center Registry Study

2014 ◽  
Vol 63 (12) ◽  
pp. S14-S15 ◽  
Author(s):  
Chih-kuo Lee ◽  
Ching-Chang Huang ◽  
Ying-Hsien Chen ◽  
Mao-Shin Lin ◽  
Hsien-Li Kao
Author(s):  
Michael Megaly ◽  
Iosif Xenogiannis ◽  
Nidal Abi Rafeh ◽  
Dimitri Karmpaliotis ◽  
Stephane Rinfret ◽  
...  

The retrograde approach has increased the success rate of chronic total occlusion percutaneous coronary intervention but has also been associated with a higher risk of complications. The retrograde approach is usually performed in complex lesions, in which the antegrade approach is not feasible or has failed previously. Using a systematic 10-step approach can maximize the likelihood of success and minimize the risks of retrograde chronic total occlusion interventions.


2017 ◽  
Vol 52 (4) ◽  
pp. 296
Author(s):  
Yudi Her Oktaviono

Chronic total occlusion recanalization still represents the final frontier in percutaneous coronary intervention. Successful revascularization is associated with improved long-term survival, reduced symptoms, improved left ventricular function and reduced need for coronary bypass surgery. Retrograde chronic total occlusion recanalization has recently become an essential complement to the classic antegrade approach. Retrograde approach through the collateral channel has been recently proposed and has the potential to improve the success rate of percutaneous coronary intervention (PCI) in chronic total occlusion (CTO) lession of the coronary arteries. We report several cases of successful CTO recanalization procedure using retrograde approach in Soetomo Hospital.


Author(s):  
C. Raghu ◽  
Rahul K. Ghogre ◽  
Alekhya Mandepudi

AbstractChronic total occlusion (CTO) is a common challenge accounting for 10% of coronary lesions found on coronary angiography. Patients are frequently referred for bypass surgery because percutaneous coronary intervention is challenging in this subset. Recent advances in the hardware as well as the technical expertise and an algorithm approach have improved the success to more than 90%.Antegrade approach is the cornerstone for managing CTO and has two distinct strategies: antegrade wire escalation, and antegrade dissection and reentry strategy. Step-wise approach to perform these procedures and the use of adjunct imaging are discussed.


Kardiologiia ◽  
2019 ◽  
Vol 59 (2) ◽  
pp. 10-16
Author(s):  
D. A. Khelimskii ◽  
O. V. Krestyaninov ◽  
A. G. Badoyan ◽  
D. N. Ponomarev ◽  
E. A. Pokushalov

Purpose:to assess results of percutaneous coronary intervention (PCI) with contemporary endovascular techniques of recanalization of chronic total coronary artery occlusions (CTO) in patients with ischemic heart disease (IHD). Occlusion (CTO) he procedural and in-hospital outcomes of consecutive patients undergoing chronic total occlusion percutaneous coronary intervention.Materials and methods.We retrospectively analyzed data from 456 consecutive patients (mean age 59.9±7.1 years, 18.2 % women) who underwent CTO PCI procedures (n=477) during 2014–2016 in the E. N. Meshalkin National Medical Research Center. CTO was localized in the right (61.2 %), left anterior descending (23.2 %) and left circumflex (15.3 %) coronary arteries. In one patient CTO was located in the left main coronary artery. According to the J-CTO score, 30 % of lesions were classified as easy, 36.4 % intermediate, 23.7 % difficult, and 18.9 % very difficult.Results.Technical and procedural successes were achieved in 374 (78.4 %) and 366 patients (76.7 %), respectively. Antegrade approach was used in 378 (79.2 %), retrograde approach – in 99 (20.7 %) cases. Retrograde approach as primary strategy was used in 27 cases (5.7 %). Most frequent access for CTO PCI was radial artery, contralateral injection was used in 151 cases (31.6 %). Total number of stents per lesion was 1.6±0.98. The mean fluoroscopy time was 36.2±31 min.Conclusions.The rate of procedural adverse events in our study was low and similar to the non-CTO PCI series. However, despite the large number of CTO PCIs, the procedural success rate was still lower than in centers with dedicated programs for the management of such patients. Thus, further work is required to overcome this difference. Possible solution of this problem might be development and introduction in clinical practice of an algorithm for CTO recanalization.


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