Outcomes with retrograde versus antegrade chronic total occlusion revascularization

Objectives The aim of the study was to evaluate the outcomes of retrograde versus antegrade approach in chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Background The retrograde approach has increased the success rate of CTO PCI but has been associated with a higher risk for...

Teljes leírás

Elmentve itt :
Bibliográfiai részletek
Szerzők: Megaly Michael
Ali Abdelrahman
Saad Marwan
Omer Mohamed
Xenogiannis Iosif
Werner Gerald S.
Karmpaliotis Dimitri
Russo Juan J.
Yamane Masahisa
Garbo Roberto
Gagnor Andrea
Ungi Imre
Rinfret Stephane
Pershad Ashish
Wojcik Jaroslaw
Dokumentumtípus: Cikk
Megjelent: 2020
Sorozat:CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS 96 No. 5
Tárgyszavak:
doi:10.1002/ccd.28616

mtmt:31000623
Online Access:http://publicatio.bibl.u-szeged.hu/22343
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245 1 0 |a Outcomes with retrograde versus antegrade chronic total occlusion revascularization  |h [elektronikus dokumentum] /  |c  Megaly Michael 
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490 0 |a CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS  |v 96 No. 5 
520 3 |a Objectives The aim of the study was to evaluate the outcomes of retrograde versus antegrade approach in chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Background The retrograde approach has increased the success rate of CTO PCI but has been associated with a higher risk for complications. Methods We conducted a meta-analysis of studies published between 2000 and August 2019 comparing the in-hospital and long-term outcomes with retrograde versus antegrade CTO PCI. Results Twelve observational studies (10,240 patients) met our inclusion criteria (retrograde approach 2,789 patients, antegrade approach 7,451 patients). Lesions treated with the retrograde approach had higher J-CTO score (2.8 vs. 1.9, p < .001). Retrograde CTO PCI was associated with a lower success rate (80.9% vs. 87.4%, p < .001). Both approaches had similar in-hospital mortality, urgent revascularization, and cerebrovascular events. Retrograde CTO PCI was associated with higher risk of in-hospital myocardial infarction (MI; odds ratio [OR] 2.37, 95% confidence intervals [CI] 1.7, 3.32, p < .001), urgent pericardiocentesis (OR 2.53, 95% CI 1.41-4.51, p = .002), and contrast-induced nephropathy (OR 2.12, 95% CI 1.47-3.08; p < .001). During a mean follow-up of 48 +/- 31 months retrograde crossing had similar mortality (OR 1.79, 95% CI 0.84-3.81, p = .13), but a higher incidence of MI (OR 2.07, 95% CI 1.1-3.88, p = .02), target vessel revascularization (OR 1.92, 95% CI 1.49-2.46, p < .001), and target lesion revascularization (OR 2.08, 95% CI 1.33-3.28, p = .001). Conclusions Compared with antegrade CTO PCI, retrograde CTO PCI is performed in more complex lesions and is associated with a higher risk for acute and long-term adverse events. 
650 4 |a Klinikai orvostan 
700 0 1 |a Ali Abdelrahman  |e aut 
700 0 1 |a Saad Marwan  |e aut 
700 0 1 |a Omer Mohamed  |e aut 
700 0 1 |a Xenogiannis Iosif  |e aut 
700 0 1 |a Werner Gerald S.  |e aut 
700 0 1 |a Karmpaliotis Dimitri  |e aut 
700 0 1 |a Russo Juan J.  |e aut 
700 0 1 |a Yamane Masahisa  |e aut 
700 0 1 |a Garbo Roberto  |e aut 
700 0 1 |a Gagnor Andrea  |e aut 
700 0 1 |a Ungi Imre  |e aut 
700 0 1 |a Rinfret Stephane  |e aut 
700 0 1 |a Pershad Ashish  |e aut 
700 0 1 |a Wojcik Jaroslaw  |e aut 
856 4 0 |u http://publicatio.bibl.u-szeged.hu/22343/1/3..pdf  |z Dokumentum-elérés