TY - JOUR
T1 - Angiographic success and procedural complications in patients undergoing retrograde percutaneous coronary chronic total occlusion interventions
T2 - A weighted meta-analysis of 3482 patients from 26 studies
AU - El Sabbagh, Abdallah
AU - Patel, Vishal G.
AU - Jeroudi, Omar M.
AU - Michael, Tesfaldet T.
AU - Alomar, Mohammed E.
AU - Mogabgab, Owen
AU - Fuh, Eric
AU - Roesle, Michele
AU - Rangan, Bavana V.
AU - Abdullah, Shuaib
AU - Hastings, Jeffrey L.
AU - Grodin, Jerrold
AU - Kumbhani, Dharam J.
AU - Alexopoulos, Dimitrios
AU - Fasseas, Panayotis
AU - Banerjee, Subhash
AU - Brilakis, Emmanouil S.
N1 - Funding Information:
Dharam Kumbhani received honoraria from American College of Cardiology and Somahlution. Dimitrios Alexopoulos received speaker honoraria from AstraZeneca. Dr. Banerjee received research grants from Gilead and the Medicines Company, received consultant/speaker honoraria from Covidien and Medtronic and has ownership in MDCARE Global (spouse) and intellectual property in HygeiaTel. Dr. Brilakis received consulting/speaker honoraria from St. Jude Medical, Terumo, Janssen, Sanofi, Asahi, Abbott Vascular, and Boston Scientific and received research support from Guerbet; his spouse is an employee of Medtronic. The other remaining authors have no conflict of interest to declare.
PY - 2014/6/15
Y1 - 2014/6/15
N2 - Background The efficacy and safety profile of retrograde chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. We sought to perform a weighted meta-analysis of the success and complication rates of retrograde CTO PCI. Methods We conducted a meta-analysis of 26 studies published between 2006 and April 2013 reporting in-hospital outcomes of retrograde CTO PCI. Data on procedural success, frequency of death, emergent coronary artery bypass graft surgery (CABG), stroke, myocardial infarction (MI), perforation, tamponade, stent thrombosis, major vascular or bleeding events, contrast nephropathy, and radiation skin injury were collected. Results A total of 26 studies with 3482 patients and 3493 target CTO lesions were included. Primary retrograde CTO PCI was attempted in 52.4%. Pooled estimates of outcomes were as follows: procedural success 83.3% [95% confidence interval (CI): 79.0% to 87.7%]; death 0.7% (95% CI: 0.5% to 1.2%); urgent CABG 0.7% (95% CI: 0.4% to 1.2%); tamponade 1.4% (95% CI: 1.0% to 2.2%); collateral perforation 6.9% (95% CI: 4.6% to 10.4%); coronary perforation 4.3% (95% CI: 1.2% to 15.4%); donor vessel dissection 2% (95% CI: 0.9% to 4.5%); stroke 0.5% (95% CI: 0.2% to 1.0%); MI 3.1% (95% CI: 0.2% to 5.0%); Q wave MI 0.6% (95% CI: 0.4% to 1.1%); vascular access complications 2% (95% CI: 0.9% to 4.5%); contrast nephropathy 1.8% (95% CI: 0.8% to 3.7%); and wire fracture and equipment entrapment 1.2% (95% CI: 0.6% to 2.5%). Conclusions Retrograde CTO PCI is associated with high procedural success rate and acceptable risk for procedural complications.
AB - Background The efficacy and safety profile of retrograde chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. We sought to perform a weighted meta-analysis of the success and complication rates of retrograde CTO PCI. Methods We conducted a meta-analysis of 26 studies published between 2006 and April 2013 reporting in-hospital outcomes of retrograde CTO PCI. Data on procedural success, frequency of death, emergent coronary artery bypass graft surgery (CABG), stroke, myocardial infarction (MI), perforation, tamponade, stent thrombosis, major vascular or bleeding events, contrast nephropathy, and radiation skin injury were collected. Results A total of 26 studies with 3482 patients and 3493 target CTO lesions were included. Primary retrograde CTO PCI was attempted in 52.4%. Pooled estimates of outcomes were as follows: procedural success 83.3% [95% confidence interval (CI): 79.0% to 87.7%]; death 0.7% (95% CI: 0.5% to 1.2%); urgent CABG 0.7% (95% CI: 0.4% to 1.2%); tamponade 1.4% (95% CI: 1.0% to 2.2%); collateral perforation 6.9% (95% CI: 4.6% to 10.4%); coronary perforation 4.3% (95% CI: 1.2% to 15.4%); donor vessel dissection 2% (95% CI: 0.9% to 4.5%); stroke 0.5% (95% CI: 0.2% to 1.0%); MI 3.1% (95% CI: 0.2% to 5.0%); Q wave MI 0.6% (95% CI: 0.4% to 1.1%); vascular access complications 2% (95% CI: 0.9% to 4.5%); contrast nephropathy 1.8% (95% CI: 0.8% to 3.7%); and wire fracture and equipment entrapment 1.2% (95% CI: 0.6% to 2.5%). Conclusions Retrograde CTO PCI is associated with high procedural success rate and acceptable risk for procedural complications.
KW - Chronic total occlusion
KW - Complications
KW - Outcomes
KW - Percutaneous coronary intervention
KW - Retrograde
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U2 - 10.1016/j.ijcard.2014.04.004
DO - 10.1016/j.ijcard.2014.04.004
M3 - Review article
C2 - 24768461
AN - SCOPUS:84901241057
SN - 0167-5273
VL - 174
SP - 243
EP - 248
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 2
ER -