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Retrograde Chronic Total Occlusion Percutaneous Coronary Interventions: Predictors of Procedural Success From the

Aung Myat1, Alfredo R Galassi2, Gerald S Werner3

  • 1Sussex Cardiac Center, Brighton, United Kingdom.

JACC. Cardiovascular Interventions
|April 22, 2022
PubMed

Insights

Predictors of success in retrograde chronic total occlusion (CTO) percutaneous coronary intervention (PCI) were identified. Key factors include less calcification, good distal vessel opacification, minimal tortuosity, visible collaterals, and high operator volume for successful PCI.

Area of Science:

  • Cardiovascular Interventions
  • Interventional Cardiology
  • Vascular Biology

Background:

  • Retrograde chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is a crucial revascularization technique.
  • Understanding predictors of procedural success is vital for optimizing outcomes in complex CTO PCI.

Purpose of the Study:

  • To identify independent predictors of procedural success in retrograde CTO PCI.
  • To elucidate factors influencing the efficacy of complex coronary interventions.

Main Methods:

  • A multivariable logistic regression model was employed.
  • Data from the European CTO (ERCTO) Club Registry (2018-2019) including 2,364 retrograde CTO PCI cases were analyzed.
  • Demographic, clinical, anatomical, and technical aspects were assessed.

Main Results:

  • Procedural success was achieved in 77.0% of cases, higher with a primary retrograde strategy (80.9%) vs. conversion (58.4%).
  • Independent predictors of success included: absence of lesion calcification (OR 1.86), high distal vessel opacification (OR 2.47), minimal proximal tortuosity (OR 1.84), favorable collateral connections (CC1 OR 4.87, CC2 OR 5.33), and high operator volume (OR 1.88).

Conclusions:

  • Absence of lesion calcification, good distal vessel opacification, minimal proximal tortuosity, visible collateral connections, and high operator volume independently predict successful retrograde CTO PCI.
  • These findings can guide procedural planning and improve success rates in complex CTO interventions.
Abstract

Keywords:
antegradechronic total occlusioncoronary collateralpercutaneous coronary interventionretrograde

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