Abstract:
BACKGROUND:Retrograde approach through collateral channels was recently proposed to increase the success rate of percutaneous coronary intervention (PCI) for coronary chronic total occlusion (CTO), but this approach is still an incompletely described technique. METHODS:We analyzed 24 cases of retrograde PCI for CTO, which were done from July 2006 to April 2008. RESULTS:Septal collaterals were more frequently used than epicardial collaterals (75% vs. 25%), without showing statistical differences in wire passage rate according to the size or location of the collaterals. Once the retrograde wire successfully crossed collateral (18/24 cases), CTO lesion was successfully crossed in all cases by using 4 different kinds of techniques: retrograde wire crossing (44%), kissing wire (22%), controlled antegrade and retrograde subintimal tracking (22%), and reverse controlled antegrade and retrograde subintimal tracking (11%). Among them, successful recanalization was achieved in 17 cases, yielding 71% retrograde PCI success rate. In failed cases with retrograde approach, 4 cases were recanalized by switching to antegrade approach. Thus, total PCI success rate was 88% (21/24 cases). There were several cases of unexpected complications mainly related to collateral-donor artery without in-hospital major adverse cardiac events (MACE). During clinical follow-up (median 10.3 months), overall MACE rate was 18% in the successful retrograde PCI group. CONCLUSIONS:The retrograde approach can improve the success rate with PCI for CTO. However, strict case selection with systemized approach is essential due to the technical complexities accompanied by the potential risk of unexpected complications.
journal_name
Int J Cardioljournal_title
International journal of cardiologyauthors
Lee NH,Seo HS,Choi JH,Suh J,Cho YHdoi
10.1016/j.ijcard.2009.04.020subject
Has Abstractpub_date
2010-10-08 00:00:00pages
219-29issue
2eissn
0167-5273issn
1874-1754pii
S0167-5273(09)00487-2journal_volume
144pub_type
杂志文章abstract::Right ventricular (RV) infarction or dysfunction is commonly complicated with acute inferior myocardial infarction. In this report, we describe a patient with unstable angina pectoris who showed a temporary isolated RV dysfunction. The patient had total occlusion of proximal right coronary artery, including RV branch,...
journal_title:International journal of cardiology
pub_type: 信件
doi:10.1016/j.ijcard.2007.01.095
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journal_title:International journal of cardiology
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journal_title:International journal of cardiology
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journal_title:International journal of cardiology
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章,评审
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journal_title:International journal of cardiology
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更新日期:2017-08-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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journal_title:International journal of cardiology
pub_type: 信件
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journal_title:International journal of cardiology
pub_type: 信件
doi:10.1016/j.ijcard.2009.03.020
更新日期:2011-05-19 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
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更新日期:1994-06-15 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2004.03.029
更新日期:2005-05-25 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/0167-5273(82)90069-9
更新日期:1982-01-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/0167-5273(93)90028-f
更新日期:1993-05-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2005.08.065
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更新日期:2009-07-24 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
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更新日期:2015-11-15 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2010.04.037
更新日期:2011-01-07 00:00:00
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journal_title:International journal of cardiology
pub_type: 临床试验,杂志文章
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更新日期:1998-01-31 00:00:00
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pub_type: 杂志文章
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更新日期:1991-04-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2014.03.022
更新日期:2014-05-01 00:00:00
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pub_type: 信件
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更新日期:2007-01-02 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
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更新日期:1994-02-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章,多中心研究
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更新日期:2017-01-15 00:00:00