Library Subscription: Guest
Begell Digital Portal Begell Digital Library eBooks Journals References & Proceedings Research Collections
Journal of Long-Term Effects of Medical Implants

ISSN Print: 1050-6934
ISSN Online: 1940-4379

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.2016017306
pages 285-293

Current Retrograde Approach Is Unfavorable to Long-Term Clinical Outcomes after Percutaneous Coronary Intervention for Chronic Total Occlusion

Zhuhua Zhang
Art Museum HouJie, Beijing Hospital of Traditional Chinese Medicine, affiliated with Capital Medical University, Beijing, Dongcheng District, Beijing, 100010, China
Dawei Zhang
Art Museum HouJie, Beijing Hospital of Traditional Chinese Medicine, affiliated with Capital Medical University, Beijing, Dongcheng District, Beijing, 100010, China
Osamu Katoh
Kusatsu Heart Center, Komaizawa-cho, Kusatsu, Shiga, 525-0014 Japan
Hongxu Liu
Art Museum HouJie, Beijing Hospital of Traditional Chinese Medicine, affiliated with Capital Medical University, Beijing, Dongcheng District, Beijing, 100010, China
Wei Tian
Art Museum HouJie, Beijing Hospital of Traditional Chinese Medicine, affiliated with Capital Medical University, Beijing, Dongcheng District, Beijing, 100010, China
Tengfei Li
Art Museum HouJie, Beijing Hospital of Traditional Chinese Medicine, affiliated with Capital Medical University, Beijing, Dongcheng District, Beijing, 100010, China
Aiyong Li
Art Museum HouJie, Beijing Hospital of Traditional Chinese Medicine, affiliated with Capital Medical University, Beijing, Dongcheng District, Beijing, 100010, China
Xin Hu
Art Museum HouJie, Beijing Hospital of Traditional Chinese Medicine, affiliated with Capital Medical University, Beijing, Dongcheng District, Beijing, 100010, China
Xiaofeng Ma
Art Museum HouJie, Beijing Hospital of Traditional Chinese Medicine, affiliated with Capital Medical University, Beijing, Dongcheng District, Beijing, 100010, China
Jian Dai
Art Museum HouJie, Beijing Hospital of Traditional Chinese Medicine, affiliated with Capital Medical University, Beijing, Dongcheng District, Beijing, 100010, China
Chenxi Zhang
Yongding Lu DongJie, Hospital of Chinese Traditional and Western Medicine, Haidian District, Beijing, 100039, China
Eisho Kyo
Kusatsu Heart Center, Komaizawa-cho, Kusatsu, Shiga, 525-0014 Japan

ABSTRACT

Surgeons currently use two different wire-based approaches to recanalize coronary chronic total occlusion (CTO): antegrade and retrograde. It has been demonstrated that the retrograde approach has improved the procedural success rate, but it remains unclear whether the retrograde approach is better than the antegrade approach for the long term. In this study, we enrolled a total of 187 patients with a diagnosis of CTOs. We evaluated the baseline characteristics of these patients and performed percutaneous coronary intervention to treat their problems by using either antegrade or retrograde approaches and different techniques in both groups. In the antegrade approach, we used three techniques: single wire, parallel wire, and side branch. The techniques in retrograde included kissing wire, controlled antegrade and retrograde subintimal tracking (CART), and reverse CART. We found that the antegrade and retrograde groups had similar baseline characteristics, with a few minor differences. Most importantly, we found that within 1 yr of the recanalizing procedure, the restenosis rate and major adverse cardiac event rate of the retrograde group were significantly higher compared to the antegrade group. We conclude that the retrograde approach may not be as beneficial as the antegrade approach for long-term clinical outcomes.