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Updated: Jun 18, 2026

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Initial experience of retrograde wire approach in coronary chronic total occlusion intervention

Suk Hwan Chung1, Moo Hyun Kim, Long Hao Yu

  • 1Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Korea.

Korean Circulation Journal
|December 2, 2009
PubMed

Insights

The retrograde approach is a valuable technique for improving success rates in coronary chronic total occlusion (CTO) interventions. This evolving method enhances procedural outcomes after mastering the learning curve.

Area of Science:

  • Cardiovascular Interventions
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Coronary chronic total occlusion (CTO) interventions present significant challenges.
  • The retrograde wire approach has emerged as a promising strategy to improve success rates.

Purpose of the Study:

  • To report the initial experience with the retrograde approach in CTO intervention.
  • To evaluate the clinical implications and effectiveness of this technique.

Main Methods:

  • Retrospective analysis of 28 patients (31 CTO lesions) undergoing retrograde approach between February 2007 and July 2008.
  • Utilized microcatheter or over-the-wire (OTW) balloon with hydrophilic guidewire via collateral channels (septal or epicardial artery).

Main Results:

  • Overall technical success rate was 64.5%.
  • Primary attempt success rate was 78.9%, decreasing to 41.7% for immediate/secondary attempts.
  • Minor complications included collateral channel dissections (3 patients); no cardiac tamponade. One patient experienced silent myocardial infarction; one failed patient died suddenly.

Conclusions:

  • The retrograde approach is an evolving technique that can enhance success rates in CTO intervention.
  • With experience gained during the learning curve, this technique becomes a valuable tool for complex CTO cases.
Abstract

Keywords:
Collateral circulationCoronary occlusion

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