Retrograde recanalization of chronic total occlusions in Europe: Procedural, in-hospital, and long-term outcomes from the multicenter ERCTO registry

Alfredo Ruggero Galassi, Thierry Lefèvre, Salvatore D. Tomasello, Valery L. Gelev, Evald H. Christiansen, Marine Castaing, Joachim H. Büttner, Bernward Lauer, Aigars Lismanis, James C. Spratt, Francesco Marzà, Marouane Boukhris, Javier Escaned, Artis Kalnins, Markus Meyer-Geßner, Andrea Gagnor, Roberto Garbo, Simon Elhadad, Mauro Carlino, Leszek BryniarskiOmer Goktekin, Georgios Sianos, Alexander Bufe, Alfredo R. Galassi, Yves Louvard, Leif Thuesen, Carlo Di Mario, Antonio Serra, Gerald S. Werner, Nicolaus Reifart, David Hildick-Smith

Risultato della ricerca: Articlepeer review

138 Citazioni (Scopus)

Abstract

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.
Lingua originaleEnglish
pagine (da-a)2388-2400
Numero di pagine13
RivistaJournal of the American College of Cardiology
Volume65
Stato di pubblicazionePublished - 2015

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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