Temporal Trends in Retrograde Crossing of Epicardial Collaterals in Chronic Total Occlusion Percutaneous Coronary Intervention

Bahadir Simsek, Spyridon Kostantinis, Judit Karacsonyi, Mir Basar Basir, Michael Megaly, Amirali Masoumi, Farouc A. Jaffer, Sevket Gorgulu, Emmanouil S. Brilakis, Khaldoon Alaswad

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: The use of retrograde crossings in chronic total occlusion (CTO) percutaneous coronary intervention (PCI) provides higher technical success rates in CTO-PCI. However, the use of epicardial collaterals carries a higher complication risk. METHODS AND RESULTS: In this study, we aimed to investigate the temporal trends in retrograde crossing of epicardial collaterals, introduction of new guidewires, in-hospital major adverse cardiovascular events (MACE), and technical success rates in a large, multinational registry. We demonstrate that technical success rates increased substantially from about 5%-10% to 76% in the past decade without a concomitant increase in MACE rate (~3% to 4%), likely associated with increased operator experience and introduction of new guidewires. In addition, we show that while high-volume centers have higher technical success, they also have higher perforation rates.

Original languageEnglish (US)
Pages (from-to)E294-E295
JournalThe Journal of invasive cardiology
Volume34
Issue number4
StatePublished - Apr 1 2022

Keywords

  • CTO-PCI
  • epicardial collaterals
  • retrograde approach

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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