TY - JOUR
T1 - Retrograde recanalization of chronic total occlusions in Europe
T2 - Procedural, in-hospital, and long-term outcomes from the multicenter ERCTO registry
AU - Galassi, Alfredo R.
AU - Sianos, Georgios
AU - Werner, Gerald S.
AU - Escaned, Javier
AU - Tomasello, Salvatore D.
AU - Boukhris, Marouane
AU - Castaing, Marine
AU - Büttner, Joachim H.
AU - Bufe, Alexander
AU - Kalnins, Artis
AU - Spratt, James C.
AU - Garbo, Roberto
AU - Hildick-Smith, David
AU - Elhadad, Simon
AU - Gagnor, Andrea
AU - Lauer, Bernward
AU - Bryniarski, Leszek
AU - Christiansen, Evald H.
AU - Thuesen, Leif
AU - Meyer-Geßner, Markus
AU - Goktekin, Omer
AU - Carlino, Mauro
AU - Louvard, Yves
AU - Lefèvre, Thierry
AU - Lismanis, Aigars
AU - Gelev, Valery L.
AU - Serra, Antonio
AU - Marzà, Francesco
AU - Di Mario, Carlo
AU - Reifart, Nicolaus
PY - 2015/6/9
Y1 - 2015/6/9
N2 - Background A retrograde approach improves the success rate of percutaneous coronary interventions (PCIs) for chronic total occlusions (CTOs). Objectives The authors describe the European experience with and outcomes of retrograde PCI revascularization for coronary CTOs. Methods Follow-up data were collected from 1,395 patients with 1,582 CTO lesions enrolled between January 2008 and December 2012 for retrograde CTO PCI at 44 European centers. Major adverse cardiac and cerebrovascular events were defined as the composite of cardiac death, myocardial infarction, stroke, and further revascularization. Results The mean patient age was 62.0 ± 10.4 years; 88.5% were men. Procedural and clinical success rates were 75.3% and 71.2%, respectively. The mean clinical follow-up duration was 24.7 ± 15.0 months. Compared with patients with failed retrograde PCI, successfully revascularized patients showed lower rates of cardiac death (0.6% vs. 4.3%, respectively; p <0.001), myocardial infarction (2.3% vs. 5.4%, respectively; p = 0.001), further revascularization (8.6% vs. 23.6%, respectively; p <0.001), and major adverse cardiac and cerebrovascular events (8.7% vs. 23.9%, respectively; p <0.001). Female sex (hazard ratio [HR]: 2.06; 95% confidence interval [CI]: 1.33 to 3.18; p = 0.001), prior PCI (HR: 1.73; 95% CI: 1.16 to 2.60; p = 0.011), low left ventricular ejection fraction (HR: 2.43; 95% CI: 1.22 to 4.83; p = 0.011), J-CTO (Multicenter CTO Registry in Japan) score ≥3 (HR: 2.08; 95% CI: 1.32 to 3.27; p = 0.002), and procedural failure (HR: 2.48; 95% CI: 1.72 to 3.57; p <0.001) were independent predictors of major adverse cardiac and cerebrovascular events at long-term follow-up. Conclusions The number of retrograde procedures in Europe has increased, with high percents of success, low rates of major complications, and good long-term outcomes.
AB - Background A retrograde approach improves the success rate of percutaneous coronary interventions (PCIs) for chronic total occlusions (CTOs). Objectives The authors describe the European experience with and outcomes of retrograde PCI revascularization for coronary CTOs. Methods Follow-up data were collected from 1,395 patients with 1,582 CTO lesions enrolled between January 2008 and December 2012 for retrograde CTO PCI at 44 European centers. Major adverse cardiac and cerebrovascular events were defined as the composite of cardiac death, myocardial infarction, stroke, and further revascularization. Results The mean patient age was 62.0 ± 10.4 years; 88.5% were men. Procedural and clinical success rates were 75.3% and 71.2%, respectively. The mean clinical follow-up duration was 24.7 ± 15.0 months. Compared with patients with failed retrograde PCI, successfully revascularized patients showed lower rates of cardiac death (0.6% vs. 4.3%, respectively; p <0.001), myocardial infarction (2.3% vs. 5.4%, respectively; p = 0.001), further revascularization (8.6% vs. 23.6%, respectively; p <0.001), and major adverse cardiac and cerebrovascular events (8.7% vs. 23.9%, respectively; p <0.001). Female sex (hazard ratio [HR]: 2.06; 95% confidence interval [CI]: 1.33 to 3.18; p = 0.001), prior PCI (HR: 1.73; 95% CI: 1.16 to 2.60; p = 0.011), low left ventricular ejection fraction (HR: 2.43; 95% CI: 1.22 to 4.83; p = 0.011), J-CTO (Multicenter CTO Registry in Japan) score ≥3 (HR: 2.08; 95% CI: 1.32 to 3.27; p = 0.002), and procedural failure (HR: 2.48; 95% CI: 1.72 to 3.57; p <0.001) were independent predictors of major adverse cardiac and cerebrovascular events at long-term follow-up. Conclusions The number of retrograde procedures in Europe has increased, with high percents of success, low rates of major complications, and good long-term outcomes.
KW - chronic total occlusions
KW - J-CTO score
KW - retrograde PCI revascularization
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U2 - 10.1016/j.jacc.2015.03.566
DO - 10.1016/j.jacc.2015.03.566
M3 - Article
AN - SCOPUS:84930913763
VL - 65
SP - 2388
EP - 2400
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 22
ER -