Changing strategies of the retrograde approach for chronic total occlusion during the past 7 years
| Autor: | Lefeng Wang, Reiko Tsukahara, Robert de Winter, Yoshiaki Ito, Hai-chang Wang, Khaled Shokry, Jiyan Chen, Toshiya Muramatsu, Hiroshi Ishimori, Seung-Jung Park |
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| Přispěvatelé: | Amsterdam Cardiovascular Sciences, Cardiology |
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Perforation (oil well) Collateral Circulation Prosthesis Design Radiography Interventional Cardiac Catheters Percutaneous Coronary Intervention Coronary Circulation Occlusion Humans Medicine Radiology Nuclear Medicine and imaging Retrograde approach Aged E-Only: Coronary Artery Disease business.industry Percutaneous coronary intervention PCI Equipment Design General Medicine Middle Aged Collateral circulation Surgery CTO Dissection Treatment Outcome Coronary Occlusion Coronary occlusion Chronic Disease Conventional PCI Female Stents Radiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | Catheterization and cardiovascular interventions, 81(4), E178-E185. Wiley-Liss Inc. Catheterization and Cardiovascular Interventions |
| ISSN: | 1522-1946 |
| Popis: | Objective We reviewed the technical changes and results achieved with the retrograde approach since we introduced it 7 years ago. Subjects and Methods The subjects were 1,268 patients who were treated for CTO between January 2004 and December 2010. They were investigated with respect to the success rate, the frequency of employing the retrograde approach and its outcome, and other factors. Results The retrograde approach was employed in ∼30% of chronic total occlusion (CTO) patients (n = 281) and the retrograde guidewire success rate was 81.1%. The kissing wire technique was substituted for the retrograde approach in 126 of the 281 patients, with antegrade crossing of a guidewire being successful in 88 of them (70%). The retrograde approach was combined with the CART and reverse controlled antegrade retrograde tracking (CART) techniques in 22 and 21 patients, respectively. Among 83 patients treated with Corsair catheters, crossing of the CTO was achieved in 63. The overall procedural success rate was 79.7% (224 patients). Complications of the retrograde approach included collateral channel dissection (2.1%), channel perforation (1.7%), CTO perforation (1.7%), and donor artery occlusion (1.1%). Conclusion The success rate and safety of the retrograde approach are both satisfactory if the appropriate devices and techniques are selected. © 2012 Wiley Periodicals, Inc. |
| Databáze: | OpenAIRE |
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