Parallel Wire Approach for Recanalisation of Chronic Total Coronary Occlusions in a Large Contemporary Multi-Center Registry.

Autor: Werner GS; Medizinische Klinik I, Klinikum Darmstadt GmbH, Darmstadt, Germany., Rathore S; Frimley Park Hospital NHS Foundation Trust, Camberley, UK., Avran A; Centre hospitalier de Valenciennes, Valenciennes, France., Garbo R; Maria Pia Hospital, GVM Care & Research, Turin, Italy., Galassi AR; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy., Lauer B; Medizinische Klinik 1, Klinikum der Friedrich-Schiller Universität, Jena, Germany., Dalibor J; Praxisklinik Herz & Gefaesse, Dresden, Germany., Boudou N; Interventional cardiology, Clinique Saint Augustin, Bordeaux, France., Gorgulu S; Biruni University Medical School, Istanbul, Turkey., Weber-Albers J; Med. Clinic I, St. Johanneshospital, Dortmund, Germany., Arenz J; Elisabeth Krankenhaus Recklinghausen, Recklinghausen, Germany., Leroy F; Hôpital Privé La Louvière, Lille, France., Lapp H; Zentralklinikum, Bad Berka, Germany., Goktekin O; Memorial Bahcelievler Hospital, Istanbul, Turkey., Ayoub M; Division of Cardiology and Angiology, Heart Center University of Bochum, Bad Oeynhausen, Germany., La Manna A; San Marco Hospital, Policlinico University Hospitals, Catania, Italy., Gasparini G; Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy., Bryniarski L; II Department of Cardiology and Cardiovascular Interventions, Jagiellonian University Medical College, Krakow, Poland., Dens J; Ziekenhuis Oost Limburg, Genk, Belgium., Bufe A; Medizinische Klinik I, Helios Klinikum, University Witten/Herdecke, Krefeld, Germany., Wojcik J; Invasive Cardiology Hospital IKARDIA, Naleczow/Lublin, Poland., Mashayekhi K; Department of Internal Medicin and Cardiology, Heartcenter Lahr, Lahr, Germany.
Jazyk: angličtina
Zdroj: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions [Catheter Cardiovasc Interv] 2024 Dec 05. Date of Electronic Publication: 2024 Dec 05.
DOI: 10.1002/ccd.31315
Abstrakt: Background: The parallel wire technique (PW) is a classic part of the antegrade strategy to open chronic total coronary occlusions (CTO).
Aims: With modern wires and dual-lumen catheters (DLC) the approach has evolved, but this progress had not been evaluated in a contemporary registry of CTO interventions.
Method: This analysis is based on 26,589 CTO procedures performed by 36 operators with > 50 procedures annually between 2015 and 2022. The different strategies and techniques were analyzed with respect to clinical and lesion characteristics, procedural resource use and periprocedural complications. Within the antegrade approach, PW was compared to antegrade wire escalation (AWE) and antegrade-dissection re-entry (ADR).
Results: The primary antegrade approach was used in 65.9%, primary retrograde in 16.9% and a strategy change in 17.2% with a wide inter-operator variability. In primary antegrade approach, PW was applied in 10.8% and ADR in 5.3%. Lesion complexity was higher in AWE and PW than with single wire, and highest in ADR procedures, leading to more complex procedures with higher contrast and radiation usage. Complications increased with ADR, while they were similar with PW and AWE. Through the observation period PW adoption increased steadily from 6.7% to 10.7%, as the DLC use facilitating PW increased from 8.3% to 17.0% over the observation period.
Conclusion: In this largest database of contemporary CTO PCI from Europe, PW adoption increased over time but remained low at about 10%. While there was a wide individual variety among the operators, it was a safe and successful technique.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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