https://scholars.lib.ntu.edu.tw/handle/123456789/533570
Title: | Retrograde Versus Antegrade Approach for Coronary Chronic Total Occlusion in an Algorithm-Driven Contemporary Asia-Pacific Multicentre Registry: Comparison of Outcomes | Authors: | Wu E.B. Tsuchikane E. Ge L. Harding S.A. Lo S. Lim S.T. Chen J.-Y. Lee S.-W. Qian J. HSIEN-LI KAO Yan B.P.Y. |
Keywords: | Chronic total occlusion; Coronary intervention; Registry data; Retrograde approach | Issue Date: | 2020 | Publisher: | Elsevier Ltd | Journal Volume: | 29 | Journal Issue: | 6 | Start page/Pages: | 894-903 | Source: | Heart Lung and Circulation | Abstract: | Background: The use of a retrograde approach and algorithm-driven CTO (chronic total occlusion) percutaneous coronary intervention (PCI) has become widespread, and many registries have reported good results. This study established a new algorithm and applied it to current CTO practice and collected a CTO registry to document the results. It compared the outcomes of a retrograde versus antegrade approach in a contemporary multicentre CTO registry. Methods: Between 1 January 2016 and 31 December 2016, consecutive patients who underwent CTO PCI performed by eight high-volume CTO operators were included in a registry. Results: During this period, 485 patients with 497 CTOs were treated with technical and procedural success rates of 93.8% and 89.9%, respectively. Antegrade and retrograde technical success was 95.9% and 91.2% (p = 0.03), respectively. Procedural success for antegrade and retrograde was 94.4% and 84.6%, respectively (p < 0.001). The pure retrograde success rate was 80% and pure antegrade success rate was 75%. Technical success in different Japanese Chronic Total Occlusion (JCTO) score groups was 100% (JCTO 0), 96.2% (JCTO 1), 95.3% (JCTO 2), and 92.5% (JCTO ? 3), with no statistical difference in success rates between different JCTO scores. In-hospital major adverse cardiac event (MACE) was 3.8% and more common in the retrograde group (6.6% vs 1.5%). Conclusions: The retrograde approach, when used by experienced operators who have been well trained in retrograde approach, can produce higher retrograde success in complex CTO lesions. The use of an algorithm approach can improve procedural efficiency, reduce contrast and radiation dosage, and reduce the time spent in failure mode. These tools remain vital to the development of future CTO PCI. ? 2019 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ) |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85068820954&doi=10.1016%2fj.hlc.2019.05.188&partnerID=40&md5=7922d56bdb36797f350f0d4a72206f77 https://scholars.lib.ntu.edu.tw/handle/123456789/533570 |
ISSN: | 1443-9506 | DOI: | 10.1016/j.hlc.2019.05.188 | SDG/Keyword: | adult; algorithm; antegrade approach; Article; chronic total occlusion; comparative effectiveness; disease registry; female; human; major adverse cardiac event; major clinical study; male; middle aged; multicenter study; percutaneous coronary intervention; priority journal; retrograde approach; risk factor; surgical approach; surgical technique; treatment outcome; algorithm; chronic disease; clinical trial; comparative study; coronary angiography; coronary artery occlusion; coronary blood vessel; diagnostic imaging; follow up; procedures; register; retrospective study; time factor; Algorithms; Chronic Disease; Coronary Angiography; Coronary Occlusion; Coronary Vessels; Female; Follow-Up Studies; Humans; Male; Middle Aged; Percutaneous Coronary Intervention; Registries; Retrospective Studies; Risk Factors; Time Factors; Treatment Outcome |
Appears in Collections: | 醫學系 |
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