Retrograde Chronic Total Occlusion Percutaneous Coronary Intervention via Saphenous Vein Graft

Iosif Xenogiannis; Fotis Gkargkoulas; Dimitri Karmpaliotis; Oleg Krestyaninov; Dmitrii Khelimskii; Farouc A. Jaffer; Jaikirshan J. Khatri; David E. Kandzari; R. Michael Wyman; Anthony H. Doing; Phil Dattilo; Catalin Toma; Robert W. Yeh; Hector Tamez; James W. Choi; Wissam Jaber; Habib Samady; Abdul M. Sheikh; Srinivasa Potluri; Mitul Patel; Ehtisham Mahmud; Basem Elbaruni; Michael P. Love; Michalis Koutouzis; Ioannis Tsiafoutis; Brian K. Jefferson; Taral Patel; Barry Uretsky; Jeffrey W. Moses; Nicholas J. Lembo; Manish Parikh; Ajay J. Kirtane; Ziad A. Ali; Allison B. Hall; Michael S. Megaly; Evangelia Vemmou; Ilias Nikolakopoulos; Bavana V. Rangan; Pamela W. Morley; Bassel Bou Dargham; Shuaib Abdullah; Santiago Garcia; Subhash Banerjee; M. Nicholas Burke; Emmanouil S. Brilakis; Khaldoon Alaswad

doi:10.1016/j.jcin.2019.10.028

Retrograde Chronic Total Occlusion Percutaneous Coronary Intervention via Saphenous Vein Graft

Iosif Xenogiannis, Fotis Gkargkoulas, Dimitri Karmpaliotis, Oleg Krestyaninov, Dmitrii Khelimskii, Farouc A. Jaffer, Jaikirshan J. Khatri, David E. Kandzari, R. Michael Wyman, Anthony H. Doing, Phil Dattilo, Catalin Toma, Robert W. Yeh, Hector Tamez, James W. Choi, Wissam Jaber, Habib Samady, Abdul M. Sheikh, Srinivasa Potluri, Mitul PatelEhtisham Mahmud, Basem Elbaruni, Michael P. Love, Michalis Koutouzis, Ioannis Tsiafoutis, Brian K. Jefferson, Taral Patel, Barry Uretsky, Jeffrey W. Moses, Nicholas J. Lembo, Manish Parikh, Ajay J. Kirtane, Ziad A. Ali, Allison B. Hall, Michael S. Megaly, Evangelia Vemmou, Ilias Nikolakopoulos, Bavana V. Rangan, Pamela W. Morley, Bassel Bou Dargham, Shuaib Abdullah, Santiago Garcia, Subhash Banerjee, M. Nicholas Burke, Emmanouil S. Brilakis, Khaldoon Alaswad

Research output: Contribution to journal › Article › peer-review

20 Scopus citations

Abstract

Objectives: The aim of this study was to examine the use of saphenous vein grafts (SVGs) for retrograde crossing during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Background: The use of SVGs for retrograde crossing during CTO PCI has received limited study. Methods: A total of 1,615 retrograde CTO PCIs performed between 2012 and 2019 at 25 centers were examined. Clinical, angiographic, and technical characteristics and procedural outcomes were compared among retrograde cases via SVGs (SVG group) versus other collateral vessels (non-SVG group). Results: Retrograde CTO PCI via SVGs was performed in 189 cases (12%). Patients in the SVG group were older (mean age 70 ± 9 years vs. 64 ± 10 years; p < 0.01) and had higher rates of prior myocardial infarction (62% vs. 51%; p < 0.01) and prior PCI (81% vs. 70%; p < 0.01). They were more likely to have moderate or severe calcification (81% vs. 65%; p < 0.01) and moderate or severe tortuosity (53% vs. 44%; p = 0.02) and had similar J-CTO (Multicenter CTO Registry in Japan) scores (3.2 ± 1.0 vs. 3.1 ± 1.1; p = 0.13) but higher PROGRESS-CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) scores (4.7 ± 1.7 vs. 3.1 ± 1.1; p < 0.01). Technical (85% vs. 78%; p = 0.04) and procedural (81% vs. 74%; p = 0.04) success rates were higher in the SVG group, with no difference in in-hospital major adverse events (6.4% vs. 4.4%; p = 0.22). Contrast volume was lower in the SVG group (225 ml [173 to 325 ml] vs. 292 ml [202 to 400 ml]; p < 0.01). Conclusions: Use of SVGs for retrograde crossing is associated with higher rates of technical and procedural success and similar rates of in-hospital major adverse cardiac events compared with retrograde CTO PCI via other collateral vessels.

Original language	English (US)
Pages (from-to)	517-526
Number of pages	10
Journal	JACC: Cardiovascular Interventions
Volume	13
Issue number	4
DOIs	https://doi.org/10.1016/j.jcin.2019.10.028
State	Published - Feb 24 2020

Keywords

chronic total occlusion
collateral
percutaneous coronary interventions
retrograde approach
saphenous vein grafts

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1016/j.jcin.2019.10.028

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Xenogiannis, I., Gkargkoulas, F., Karmpaliotis, D., Krestyaninov, O., Khelimskii, D., Jaffer, F. A., Khatri, J. J., Kandzari, D. E., Wyman, R. M., Doing, A. H., Dattilo, P., Toma, C., Yeh, R. W., Tamez, H., Choi, J. W., Jaber, W., Samady, H., Sheikh, A. M., Potluri, S., ... Alaswad, K. (2020). Retrograde Chronic Total Occlusion Percutaneous Coronary Intervention via Saphenous Vein Graft. JACC: Cardiovascular Interventions, 13(4), 517-526. https://doi.org/10.1016/j.jcin.2019.10.028

Xenogiannis, I, Gkargkoulas, F, Karmpaliotis, D, Krestyaninov, O, Khelimskii, D, Jaffer, FA, Khatri, JJ, Kandzari, DE, Wyman, RM, Doing, AH, Dattilo, P, Toma, C, Yeh, RW, Tamez, H, Choi, JW, Jaber, W, Samady, H, Sheikh, AM, Potluri, S, Patel, M, Mahmud, E, Elbaruni, B, Love, MP, Koutouzis, M, Tsiafoutis, I, Jefferson, BK, Patel, T, Uretsky, B, Moses, JW, Lembo, NJ, Parikh, M, Kirtane, AJ, Ali, ZA, Hall, AB, Megaly, MS, Vemmou, E, Nikolakopoulos, I, Rangan, BV, Morley, PW, Bou Dargham, B, Abdullah, S, Garcia, S, Banerjee, S, Burke, MN, Brilakis, ES & Alaswad, K 2020, 'Retrograde Chronic Total Occlusion Percutaneous Coronary Intervention via Saphenous Vein Graft', JACC: Cardiovascular Interventions, vol. 13, no. 4, pp. 517-526. https://doi.org/10.1016/j.jcin.2019.10.028

@article{2fad3f9d97e14be8b438f67ddbc02baf,

title = "Retrograde Chronic Total Occlusion Percutaneous Coronary Intervention via Saphenous Vein Graft",

abstract = "Objectives: The aim of this study was to examine the use of saphenous vein grafts (SVGs) for retrograde crossing during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Background: The use of SVGs for retrograde crossing during CTO PCI has received limited study. Methods: A total of 1,615 retrograde CTO PCIs performed between 2012 and 2019 at 25 centers were examined. Clinical, angiographic, and technical characteristics and procedural outcomes were compared among retrograde cases via SVGs (SVG group) versus other collateral vessels (non-SVG group). Results: Retrograde CTO PCI via SVGs was performed in 189 cases (12%). Patients in the SVG group were older (mean age 70 ± 9 years vs. 64 ± 10 years; p < 0.01) and had higher rates of prior myocardial infarction (62% vs. 51%; p < 0.01) and prior PCI (81% vs. 70%; p < 0.01). They were more likely to have moderate or severe calcification (81% vs. 65%; p < 0.01) and moderate or severe tortuosity (53% vs. 44%; p = 0.02) and had similar J-CTO (Multicenter CTO Registry in Japan) scores (3.2 ± 1.0 vs. 3.1 ± 1.1; p = 0.13) but higher PROGRESS-CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) scores (4.7 ± 1.7 vs. 3.1 ± 1.1; p < 0.01). Technical (85% vs. 78%; p = 0.04) and procedural (81% vs. 74%; p = 0.04) success rates were higher in the SVG group, with no difference in in-hospital major adverse events (6.4% vs. 4.4%; p = 0.22). Contrast volume was lower in the SVG group (225 ml [173 to 325 ml] vs. 292 ml [202 to 400 ml]; p < 0.01). Conclusions: Use of SVGs for retrograde crossing is associated with higher rates of technical and procedural success and similar rates of in-hospital major adverse cardiac events compared with retrograde CTO PCI via other collateral vessels.",

keywords = "chronic total occlusion, collateral, percutaneous coronary interventions, retrograde approach, saphenous vein grafts",

author = "Iosif Xenogiannis and Fotis Gkargkoulas and Dimitri Karmpaliotis and Oleg Krestyaninov and Dmitrii Khelimskii and Jaffer, {Farouc A.} and Khatri, {Jaikirshan J.} and Kandzari, {David E.} and Wyman, {R. Michael} and Doing, {Anthony H.} and Phil Dattilo and Catalin Toma and Yeh, {Robert W.} and Hector Tamez and Choi, {James W.} and Wissam Jaber and Habib Samady and Sheikh, {Abdul M.} and Srinivasa Potluri and Mitul Patel and Ehtisham Mahmud and Basem Elbaruni and Love, {Michael P.} and Michalis Koutouzis and Ioannis Tsiafoutis and Jefferson, {Brian K.} and Taral Patel and Barry Uretsky and Moses, {Jeffrey W.} and Lembo, {Nicholas J.} and Manish Parikh and Kirtane, {Ajay J.} and Ali, {Ziad A.} and Hall, {Allison B.} and Megaly, {Michael S.} and Evangelia Vemmou and Ilias Nikolakopoulos and Rangan, {Bavana V.} and Morley, {Pamela W.} and {Bou Dargham}, Bassel and Shuaib Abdullah and Santiago Garcia and Subhash Banerjee and Burke, {M. Nicholas} and Brilakis, {Emmanouil S.} and Khaldoon Alaswad",

note = "Publisher Copyright: {\textcopyright} 2020 American College of Cardiology Foundation",

year = "2020",

month = feb,

day = "24",

doi = "10.1016/j.jcin.2019.10.028",

language = "English (US)",

volume = "13",

pages = "517--526",

journal = "JACC: Cardiovascular Interventions",

issn = "1936-8798",

publisher = "Elsevier Inc.",

number = "4",

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TY - JOUR

T1 - Retrograde Chronic Total Occlusion Percutaneous Coronary Intervention via Saphenous Vein Graft

AU - Xenogiannis, Iosif

AU - Gkargkoulas, Fotis

AU - Karmpaliotis, Dimitri

AU - Krestyaninov, Oleg

AU - Khelimskii, Dmitrii

AU - Jaffer, Farouc A.

AU - Khatri, Jaikirshan J.

AU - Kandzari, David E.

AU - Wyman, R. Michael

AU - Doing, Anthony H.

AU - Dattilo, Phil

AU - Toma, Catalin

AU - Yeh, Robert W.

AU - Tamez, Hector

AU - Choi, James W.

AU - Jaber, Wissam

AU - Samady, Habib

AU - Sheikh, Abdul M.

AU - Potluri, Srinivasa

AU - Patel, Mitul

AU - Mahmud, Ehtisham

AU - Elbaruni, Basem

AU - Love, Michael P.

AU - Koutouzis, Michalis

AU - Tsiafoutis, Ioannis

AU - Jefferson, Brian K.

AU - Patel, Taral

AU - Uretsky, Barry

AU - Moses, Jeffrey W.

AU - Lembo, Nicholas J.

AU - Parikh, Manish

AU - Kirtane, Ajay J.

AU - Ali, Ziad A.

AU - Hall, Allison B.

AU - Megaly, Michael S.

AU - Vemmou, Evangelia

AU - Nikolakopoulos, Ilias

AU - Rangan, Bavana V.

AU - Morley, Pamela W.

AU - Bou Dargham, Bassel

AU - Abdullah, Shuaib

AU - Garcia, Santiago

AU - Banerjee, Subhash

AU - Burke, M. Nicholas

AU - Brilakis, Emmanouil S.

AU - Alaswad, Khaldoon

PY - 2020/2/24

Y1 - 2020/2/24

N2 - Objectives: The aim of this study was to examine the use of saphenous vein grafts (SVGs) for retrograde crossing during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Background: The use of SVGs for retrograde crossing during CTO PCI has received limited study. Methods: A total of 1,615 retrograde CTO PCIs performed between 2012 and 2019 at 25 centers were examined. Clinical, angiographic, and technical characteristics and procedural outcomes were compared among retrograde cases via SVGs (SVG group) versus other collateral vessels (non-SVG group). Results: Retrograde CTO PCI via SVGs was performed in 189 cases (12%). Patients in the SVG group were older (mean age 70 ± 9 years vs. 64 ± 10 years; p < 0.01) and had higher rates of prior myocardial infarction (62% vs. 51%; p < 0.01) and prior PCI (81% vs. 70%; p < 0.01). They were more likely to have moderate or severe calcification (81% vs. 65%; p < 0.01) and moderate or severe tortuosity (53% vs. 44%; p = 0.02) and had similar J-CTO (Multicenter CTO Registry in Japan) scores (3.2 ± 1.0 vs. 3.1 ± 1.1; p = 0.13) but higher PROGRESS-CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) scores (4.7 ± 1.7 vs. 3.1 ± 1.1; p < 0.01). Technical (85% vs. 78%; p = 0.04) and procedural (81% vs. 74%; p = 0.04) success rates were higher in the SVG group, with no difference in in-hospital major adverse events (6.4% vs. 4.4%; p = 0.22). Contrast volume was lower in the SVG group (225 ml [173 to 325 ml] vs. 292 ml [202 to 400 ml]; p < 0.01). Conclusions: Use of SVGs for retrograde crossing is associated with higher rates of technical and procedural success and similar rates of in-hospital major adverse cardiac events compared with retrograde CTO PCI via other collateral vessels.

AB - Objectives: The aim of this study was to examine the use of saphenous vein grafts (SVGs) for retrograde crossing during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Background: The use of SVGs for retrograde crossing during CTO PCI has received limited study. Methods: A total of 1,615 retrograde CTO PCIs performed between 2012 and 2019 at 25 centers were examined. Clinical, angiographic, and technical characteristics and procedural outcomes were compared among retrograde cases via SVGs (SVG group) versus other collateral vessels (non-SVG group). Results: Retrograde CTO PCI via SVGs was performed in 189 cases (12%). Patients in the SVG group were older (mean age 70 ± 9 years vs. 64 ± 10 years; p < 0.01) and had higher rates of prior myocardial infarction (62% vs. 51%; p < 0.01) and prior PCI (81% vs. 70%; p < 0.01). They were more likely to have moderate or severe calcification (81% vs. 65%; p < 0.01) and moderate or severe tortuosity (53% vs. 44%; p = 0.02) and had similar J-CTO (Multicenter CTO Registry in Japan) scores (3.2 ± 1.0 vs. 3.1 ± 1.1; p = 0.13) but higher PROGRESS-CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) scores (4.7 ± 1.7 vs. 3.1 ± 1.1; p < 0.01). Technical (85% vs. 78%; p = 0.04) and procedural (81% vs. 74%; p = 0.04) success rates were higher in the SVG group, with no difference in in-hospital major adverse events (6.4% vs. 4.4%; p = 0.22). Contrast volume was lower in the SVG group (225 ml [173 to 325 ml] vs. 292 ml [202 to 400 ml]; p < 0.01). Conclusions: Use of SVGs for retrograde crossing is associated with higher rates of technical and procedural success and similar rates of in-hospital major adverse cardiac events compared with retrograde CTO PCI via other collateral vessels.

KW - chronic total occlusion

KW - collateral

KW - percutaneous coronary interventions

KW - retrograde approach

KW - saphenous vein grafts

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JO - JACC: Cardiovascular Interventions

JF - JACC: Cardiovascular Interventions

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ER -

Retrograde Chronic Total Occlusion Percutaneous Coronary Intervention via Saphenous Vein Graft

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