Key result
Previous anterograde intervention for CTO target vessels (OR 0.875; 95% CI 0.779-0.940; P=0.026) and intervention of other vessels were significant risk factors for retrograde approach failure.
Why the study?
Failure factors in retrograde wire-guided cannulation for the treatment of coronary chronic total occlusion remained to be investigated.
What are the risk factors for procedural failure in retrograde wire-guided intervention for chronic total occlusion?
Observational (n=285)
No
What are the risk factors for procedural failure in retrograde wire-guided intervention for chronic total occlusion?
In patients undergoing retrograde intervention for CTO, procedural success is negatively impacted by the number of diseased vessels, collateral circulation, previous anterograde attempts, and concurrent intervention of other vessels.
May inform retrograde CTO PCI selection; leaves open prospective validation of these risk factors.
OBJECTIVE: This study aims to investigate failure factors in retrograde wire-guided cannulation (retrograde approach) for the treatment of coronary chronic total occlusion (CTO). METHODS: Data of 285 patients treated for CTO using retrograde approach in the General Hospital of Shenyang Military Region from August 2004 to May 2016 were collected. RESULTS: The average age of the 285 patients was 63.89 ± 11.3 years old. Multivariate analysis revealed that the operation risk factors include the number of diseased vessels, collateral circulation, as well as whether anterograde intervention for CTO target vessels was previously performed (OR = 0.875, 95% CI = 0.779-0.940, P= 0.026) and whether other vessels were intervened (OR = 22.372, 95% CI = 2.059-243.031, P= 0.011). CONCLUSION: Based on the present study, the success rate of retrograde approach for CTO was negatively correlated with the number of diseased vessels and collateral circulation. It was furthermore of importance whether anterograde intervention for CTO target vessels was previously performed and whether other vessels beside CTO vessels were intervened, which were also risk factors.
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Tian et al. (2019) conducted an observational in Coronary chronic total occlusion (CTO) (n=285). Previous anterograde intervention for CTO target vessels was evaluated on Failure of retrograde wire-guided cannulation (OR 0.875, 95% CI 0.779-0.940, p=0.026). Previous anterograde intervention for CTO target vessels (OR 0.875; 95% CI 0.779-0.940; P=0.026) and intervention of other vessels were significant risk factors for retrograde approach failure.
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