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Advances in Retrograde Chronic Total Occlusion Percutaneous Coronary Intervention: Techniques, Outcomes, and Evolving
Madeleine Barker1, Tony J De Martini2
1Division of Cardiology, Emory University Hospital, 1364 Clifton Road Northeast, Atlanta, GA 30322, USA.
Abstract:
Retrograde chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has significantly increased success rates for complex coronary lesions. In this comprehensive practical review, we outline indications for retrograde access, optimal collateral selection, and techniques including collateral crossing, wire escalation, and reverse controlled antegrade and retrograde subintimal tracking with emphasis on minimizing donor artery trauma and managing complications. Advanced wire and microcatheter technologies, along with stepwise troubleshooting, have made this technique safer and more reproducible in skilled hands. The review equips interventionalists with essential knowledge for successful and safe retrograde CTO PCI.
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