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Comparison of the ipsi-lateral versus contra-lateral retrograde approach of percutaneous coronary interventions in chronic total occlusions.
Mashayekhi, Kambis; Behnes, Michael; Valuckiene, Zivile; Bryniarski, Leszek; Akin, Ibrahim; Neuser, Hans; Neumann, Franz-Josef; Reifart, Nicolaus.
Afiliación
  • Mashayekhi K; Internal Medicine Clinic II, Helios Vogtland Klinikum Plauen, Plauen, Germany.
  • Behnes M; Division of Cardiology and Angiology II, University Heart Center Freiburg Bad Krozingen, Bad Krozingen, Germany.
  • Valuckiene Z; First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany.
  • Bryniarski L; Internal Medicine Clinic II, Helios Vogtland Klinikum Plauen, Plauen, Germany.
  • Akin I; Department of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
  • Neuser H; Department of Cardiology, Interventional Electrocardiology and Hypertension; Institute of Cardiology, Jagiellonian University Medical College, Krakau, Poland.
  • Neumann FJ; First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany.
  • Reifart N; Internal Medicine Clinic II, Helios Vogtland Klinikum Plauen, Plauen, Germany.
Catheter Cardiovasc Interv ; 89(4): 649-655, 2017 Mar 01.
Article en En | MEDLINE | ID: mdl-27377426
BACKGROUND: Retrograde recanalization of coronary chronic total occlusions (CTO) via contralateral (CL) collateral connections (CCs) is successful in 60-70% of patients in whom conventional antegrade approach fails or is unpromising. This study describes our experience with retrograde CTO-PCI via ipsi-lateral (IL) CCs in patients with unfavorable CL CCs. METHODS: Between January 2013 and September 2015, 392 consecutive CTO procedures were performed by two high volume CTO-operators and the relevant data were fed into an online registry (ERCTO® EuroCTO-club). Most patients (222/392; 57%) were approached antegradely, whereas 43% were attempted retrogradely (170/392). After exclusion of all procedures performed via bypass-grafts (n = 12), PCI via CL CCs, the CL-group (n = 114/158; 72%), was compared with the IL-group that was attempted via IL CCs (n = 44/158; 28%). RESULTS: Both groups were similar with respect to risk factors and morphologic criteria of CTO-severity. The initial primary strategy was successful in 78% in the CL-group and in 68% in the IL-group. In both patient groups, the initial strategy had to be switched in five patients from CL toward IL (4.4%, n = 5/114) and from IL to CL (11.3% n = 5/44). The rate of major complications was 7% (CL) and 5% (IL), respectively (n.s.). After retrograde failure and cross-over to an antegrade controlled re-entry strategy the overall success rates increased to 92% (CL) and 93% (IL). CONCLUSIONS: In experienced hands retrograde CTO-PCI via IL CCs appears as safe and successful as the CL approach. © 2016 Wiley Periodicals, Inc.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sistema de Registros / Circulación Colateral / Oclusión Coronaria / Intervención Coronaria Percutánea Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Catheter Cardiovasc Interv Asunto de la revista: CARDIOLOGIA Año: 2017 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sistema de Registros / Circulación Colateral / Oclusión Coronaria / Intervención Coronaria Percutánea Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Catheter Cardiovasc Interv Asunto de la revista: CARDIOLOGIA Año: 2017 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Estados Unidos