In:
Catheterization and Cardiovascular Interventions, Wiley, Vol. 97, No. 6 ( 2021-05), p. 1162-1173
Abstract:
We sought to assess in‐hospital and long‐term outcomes of retrograde compared with antegrade‐only percutaneous coronary intervention for chronic total occlusion (CTO PCI). Background Procedural and clinical outcomes following retrograde compared with antegrade‐only CTO PCI remain unknown. Methods Using the core‐lab adjudicated OPEN‐CTO registry, we compared the outcomes of retrograde to antegrade‐only CTO PCI. Primary endpoints included were in‐hospital major adverse cardiac and cerebrovascular events (MACCE) (all‐cause death, stroke, myocardial infarction [MI], emergency cardiac surgery, or clinically significant perforation) and MACCE at 1‐year (all‐cause death, MI, stroke, target lesion revascularization, or target vessel reocclusion). Results Among 885 single CTO procedures from the OPEN‐CTO registry, 454 were retrograde and 431 were antegrade‐only. Lesion complexity was higher (J‐CTO score: 2.7 vs. 1.9; p 〈 .001) and technical success lower (82.4 vs. 94.2%; p 〈 .001) in retrograde compared with antegrade‐only procedures. All‐cause death was higher in the retrograde group in‐hospital (2 vs. 0%; p = .003), but not at 1‐year (4.9 vs. 3.3%; p = .29). Compared with antegrade‐only procedures, in‐hospital MACCE rates (composite of all‐cause death, stroke, MI, emergency cardiac surgery, and clinically significant perforation) were higher in the retrograde group (10.8 vs. 3.3%; p 〈 .001) and at 1‐year (19.5 vs. 13.9%; p = .03). In sensitivity analyses landmarked at discharge, there was no difference in MACCE rates at 1 year following retrograde versus antegrade‐only CTO PCI. Improvements in Seattle Angina Questionnaire Quality of Life scores at 1‐year were similar between the retrograde and antegrade‐only groups (29.9 vs 30.4; p = .58). Conclusions In the OPEN‐CTO registry, retrograde CTO procedures were associated with higher rates of in‐hospital MACCE compared with antegrade‐only; however, post‐discharge outcomes, including quality of life improvements, were similar between technical modalities.
Type of Medium:
Online Resource
ISSN:
1522-1946
,
1522-726X
Language:
English
Publisher:
Wiley
Publication Date:
2021
detail.hit.zdb_id:
2001555-0
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