Retrograde chronic total occlusion percutaneous coronary intervention through ipsilateral collateral channels

• Verfasst von: Azzalini, Lorenzo [VerfasserIn]
• Verfasst von: Behnes, Michael [VerfasserIn]
• Verfasst von: Akın, Ibrahim [VerfasserIn]
• Titel: Retrograde chronic total occlusion percutaneous coronary intervention through ipsilateral collateral channels
• Titelzusatz: a multicenter registry
• Verf.angabe: Lorenzo Azzalini, Pierfrancesco Agostoni, Susanna Benincasa, Paul Knaapen, Stefan P. Schumacher, Joseph Dens, Joren Maeremans, Adriaan O. Kraaijeveld, Leo Timmers, Michael Behnes, Ibrahim Akin, Aurel Toma, Franz-Josef Neumann, Antonio Colombo, Mauro Carlino, Kambis Mashayekhi
• E-Jahr: 2017
• Jahr: 7 August 2017
• Umfang: 9 S.
• Fussnoten: Gesehen am 28.05.2018
• Titel Quelle: Enthalten in: American College of CardiologyJACC Cardiovascular interventions
• Ort Quelle: New York, NY : Elsevier, 2008
• Jahr Quelle: 2017
• Band/Heft Quelle: 10(2017), 15, Seite 1489-1497
• ISSN Quelle: 1876-7605
• DOI: doi:10.1016/j.jcin.2017.06.002
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: chronic total occlusion
• Sach-SW: collateral channels
• Sach-SW: epicardial
• Sach-SW: ipsilateral
• Sach-SW: percutaneous coronary intervention
• Sach-SW: retrograde
• K10plus-PPN: 1575542188

Abstract

Objectives: The aim of this study was to describe the procedural aspects and outcomes of retrograde chronic total occlusion (CTO) percutaneous coronary intervention (PCI) through ipsilateral collateral channels (ILCs). Background: Retrograde CTO PCI via ILCs is rarely performed, usually when no other retrograde options exist, and available evidence derives mostly from case reports. Methods: A large retrospective multinational registry was compiled, including all consecutive patients undergoing retrograde CTO PCI through ILCs at 6 centers between September 2011 and October 2016. Success rates, as well as procedural complications and in-hospital outcomes, were studied. Results: A total of 126 patients (17% of all retrograde CTO PCIs) were included. The mean age was 65.7 ± 11.2 years, and the mean J-CTO (Multicenter CTO Registry in Japan) score was 2.36 ± 1.13. The target vessel was the circumflex coronary artery in 42%, the left anterior descending coronary artery in 39%, and the right coronary artery in 19%. The ILCs used were epicardial in 76% and septal in 24%. ILC anatomy was very heterogeneous. One guiding catheter was used in 80%, whereas the ping-pong technique was used in 20%. A retrograde wire could be advanced to the distal cap in 81%. Technical and procedural success rates were 87% and 82%, respectively. ILC perforation with need for intervention was observed in 5.6% and tamponade due to ILC perforation in 2.4%. One patient (0.8%) died. Conclusions: Retrograde CTO PCI through ILCs is a challenging intervention that can be performed in difficult occlusions with high success rates and reasonable rates of complications by experienced operators