Abstract 11671: Management of Procedural Complications Related to Percutaneous Coronary Intervention of Chronic Total Occlusions via the Retrograde Approach. A Toyohashi Experience
Background: The recanalization of chronic total occlusions (CTOs) in native coronary arteries no doubt represents one of the most technically challenging of interventional procedures. Despite recent high success rates owing to the development of new strategies such as the retrograde approach, complications and their management during percutaneous coronary intervention (PCI) of CTOs have not been fully evaluated.
Methods: The aim of this study was to investigate in-hospital outcomes, including complications, with the retrograde approach.
Results: Of 1,014 CTOs in 943 patients who underwent PCI between 2005 and 2010, 278 CTOs (27.6%) were attempted using the retrograde approach. The overall procedural success rate was 80% (221/278). CTO lesions were most frequently located in the right coronary artery (n=166) followed by the left anterior descending artery (n=80), and the left circumflex artery (n=33). Septal, epicardial, and saphenous vein graft collaterals were used in 67.3%, 24.8%, and 7.9% of cases involving the retrograde approach, respectively. Specific complications with the retrograde approach were observed in 36 41 cases (14.7%) and were recovered in the cath-lab with the exception of 1 case as shown in the table.
Conclusions: Although the complication rate during the retrograde approach was around 15%, all cases were solved with optimal treatments. A safe procedure with careful wire manipulation and appropriate? management should be required for the retrograde approach.
- © 2011 by American Heart Association, Inc.