Outcomes With the Use of the Retrograde Approach for Coronary Chronic Total Occlusion Interventions in a Contemporary Multicenter US Registry
Key result
Retrograde CTO PCI is linked to lower technical success and ~291% higher MACE vs antegrade crossing.
- P<0.001
- n=1,301
Why the study?
Does the retrograde approach improve outcomes in chronic total occlusion percutaneous coronary intervention compared to antegrade-only approach?
Population
1301 procedures for chronic total occlusion percutaneous coronary intervention performed at 11 experienced…
Comparison
Retrograde approach for chronic total occlusion… vs Antegrade-only approach for chronic total…
Design
Cohort
Follow-up
in-hospital
Authors
Discussion
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Implication
Retrograde CTO PCI was associated with lower success and higher MACE in complex lesions; leaves open optimal strategy selection.
Study Design
Type
Observational (n=1,301)
Multicenter
Yes
Structured PICO
Does the retrograde approach improve outcomes in chronic total occlusion percutaneous coronary intervention compared to antegrade-only approach?
P
Population
1301 procedures for chronic total occlusion percutaneous coronary intervention (CTO PCI) performed at 11 experienced US centers. Mean age 65.5±10 years, 84% men, 45% diabetes mellitus, 34% previous coronary artery bypass graft surgery.
I
Intervention
Retrograde approach for chronic total occlusion percutaneous coronary intervention (used as initial strategy or after failed antegrade attempt)
C
Comparator
Antegrade-only approach for chronic total occlusion percutaneous coronary intervention
O
Outcome
Technical success and in-hospital major adverse cardiovascular events (MACE)composite
Main Result
Absolute Event Rate: 4.3% vs 1.1%
p-value: p=<0.001
The retrograde approach for CTO PCI is frequently utilized for highly complex lesions and, despite lower success and higher complication rates compared to antegrade-only crossing, remains essential for achieving high overall procedural success.
Cite This Study
Karmpaliotis et al. (2016) conducted an observational in Chronic total occlusion (n=1,301). Retrograde approach vs. Antegrade-only approach was evaluated on In-hospital major adverse cardiovascular events (p=<0.001). The retrograde approach for chronic total occlusion PCI was associated with lower technical success (85% vs 94%; P<0.001) and higher MACE (4.3% vs 1.1%; P<0.001) compared to antegrade-only crossing.