Key result
Primary retrograde approach linked to ~9% higher initial guidewire success vs antegrade in complex CTOs.
Why the study?
It remains unclear whether the primary retrograde approach offers benefits in terms of procedural success and burden/resource use in challenging CTO-PCI cases.
Cohort (n=380)
No
Answers are grounded in this paper and cite their sources.
PRA may ease complex CTO-PCI cases; leaves open optimal first strategy without randomized confirmation.
Background: The retrograde approach improves the procedural success rate of chronic total occlusion percutaneous coronary interventions (CTO-PCIs). However, it remains unclear whether the primary retrograde approach (PRA) offers benefits in terms of procedural success and burden/resource use in challenging cases. Therefore, we compared efficacy between the primary antegrade approach (PAA) and PRA in complex CTO-PCIs.
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Qayed et al. (2026) conducted a cohort in Complex Chronic Total Occlusions (n=380). Primary retrograde approach vs. Primary antegrade approach was evaluated on Initial guidewire success (p=0.01). The primary retrograde approach achieved a significantly higher initial guidewire success rate than the primary antegrade approach (88.1% vs. 78.9%) in patients with complex chronic total occlusions.
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