Key result
Retrograde CTO PCI achieves up to ~95% procedural success with advanced techniques.
The retrograde approach is a crucial technique in CTO PCI that, when combined with modern equipment and techniques like reverse CART, can achieve high success rates in complex lesions.
Supports retrograde CTO PCI by experienced operators in complex lesions; leaves open need for randomized outcome data.
Coronary chronic total occlusion (CTO) is a frequent finding in patients with coronary artery disease. It remains one of the most challenging subsets, accounting for 10-20% of all percutaneous coronary interventions (PCI). Although remarkable progress in PCI has been made, it is reasonable to state that successful recanalization of CTO represents the “last frontier" of PCI. PCI of CTOs has been limited historically by technical success rates of 50-70%. The introduction of enhanced guidewires, microcatheter, channel dilatator with increasing operator experience, and innovative techniques such as the retrograde approach have raised hopes for better outcomes. This article goes into depth into various strategies of retrograde approach in CTO.
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Debabrata Dash (2015) conducted a review in Coronary chronic total occlusion (CTO). Retrograde approach for percutaneous coronary intervention vs. Antegrade approach (historical) was evaluated. The retrograde approach for percutaneous coronary intervention of chronic total occlusions, utilizing advanced techniques and equipment, can achieve procedural success rates of up to 95%.
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