Edith and Benson Ford Heart and Vascular Institute, Henry Ford Hospital & Health System, 2799 W. Grand Blvd Detroit, MI 48202 USA.
J Invasive Cardiol. 2022 Apr;34(4):E294-E295. doi: 10.25270/jic/21.00434. Epub 2022 Mar 18.
The use of retrograde crossings in chronic total occlusion (CTO) percutaneous coronary intervention (PCI) provides higher technical success rates in CTO-PCI. However, the use of epicardial collaterals carries a higher complication risk.
In this study, we aimed to investigate the temporal trends in retrograde crossing of epicardial collaterals, introduction of new guidewires, in-hospital major adverse cardiovascular events (MACE), and technical success rates in a large, multinational registry. We demonstrate that technical success rates increased substantially from about 5%-10% to 76% in the past decade without a concomitant increase in MACE rate (~3% to 4%), likely associated with increased operator experience and introduction of new guidewires. In addition, we show that while high-volume centers have higher technical success, they also have higher perforation rates.
逆行导丝技术在慢性完全闭塞（CTO）经皮冠状动脉介入治疗（PCI）中可提高 CTO-PCI 的技术成功率。然而，使用心外膜侧支血管会增加并发症风险。
在这项研究中，我们旨在调查心外膜侧支逆行导丝技术、新型导丝的应用、住院期间主要不良心血管事件（MACE）和大型跨国注册中心的技术成功率的时间趋势。我们发现，过去十年间，技术成功率从约 5%-10%大幅提高至 76%，而 MACE 发生率（约 3%至 4%）没有相应增加，这可能与术者经验的增加和新型导丝的应用有关。此外，我们还发现，高容量中心的技术成功率虽然较高，但穿孔率也较高。
