慢性完全闭塞经皮冠状动脉介入治疗中的设备利用情况：来自 PROGRESS-CTO 注册研究的最新进展。

Equipment Utilization in Chronic Total Occlusion Percutaneous Coronary Interventions: Update From the PROGRESS-CTO Registry.

机构信息

Minneapolis Heart Institute, Chairman of the Center for Coronary Artery Disease at the Minneapolis Heart Institute Foundation, 920 E 28th Street #300, Minneapolis, MN 55407 USA.

出版信息

J Invasive Cardiol. 2023 Feb;35(2):E61-E69. doi: 10.25270/jic/22.00322.

DOI:10.25270/jic/22.00322

PMID:36735869

Abstract

BACKGROUND

Guidewires and microcatheters are critical to the success of chronic total occlusion (CTO) percutaneous coronary intervention (PCI).

METHODS

We examined equipment utilization in 11,202 CTO-PCIs performed in 10,952 patients at 42 United States (US) and non-US centers between 2012 and 2022.

RESULTS

Antegrade-only crossing was attempted in 7628 CTO-PCIs (68%) and the retrograde approach was used in 3574 CTO-PCIs (32%). The median number of guidewires used during antegrade wiring increased with lesion complexity from 3 (interquartile range [IQR], 2-4) for J-CTO score of 0 to 5 (IQR, 4-7) for J-CTO score of 5 (P<.001). Antegrade-only procedures had higher technical (90% vs 79%; P<.001) and procedural success (89% vs 77%; P<.001) compared with retrograde procedures. In antegrade-only cases, Pilot 200 (28%; Abbott Vascular) and Fielder XT (24%; Asahi Intecc) were the most frequently used guidewires, while Corsair (21%; Asahi Intecc) and Turnpike Spiral (20%; Vascular Solutions) were the most commonly used microcatheters. In retrograde cases, Sion (32%; Asahi Intecc) was the most common guidewire used, followed by Sion Black (22%; Asahi Intecc), Pilot 200 (22%), and Suoh 03 (19%; Asahi Intecc), while Corsair (16%) and Turnpike LP (11%) were the most commonly used microcatheters. The most successful guidewire for collateral crossing was the Sion (32%), followed by Sion Black (15%) and Suoh 03 (11%).

CONCLUSION

Polymer-jacketed guidewires are the most commonly used guidewires for antegrade wiring, while non-polymer-jacketed, torquable guidewires are the most frequently used guidewires for retrograde techniques. Turnpike and Corsair are the most commonly used microcatheters in CTO-PCI.

摘要

背景

导丝和微导管对于慢性完全闭塞（CTO）经皮冠状动脉介入（PCI）的成功至关重要。

方法

我们检查了 2012 年至 2022 年期间在美国和非美国的 42 个中心进行的 10952 例患者的 11202 例 CTO-PCI 中设备的使用情况。

结果

在 7628 例 CTO-PCI（68%）中尝试了单纯前向交叉，在 3574 例 CTO-PCI（32%）中使用了逆行技术。在前向布线过程中，导丝的中位数数量随病变复杂性而增加，从 J-CTO 评分 0 时的 3（四分位距 [IQR]，2-4）增加到 J-CTO 评分 5 时的 4-7（P<.001）。与逆行技术相比，单纯前向手术具有更高的技术成功率（90%比 79%；P<.001）和手术成功率（89%比 77%；P<.001）。在单纯前向病例中，Pilot 200（28%；Abbott Vascular）和 Fielder XT（24%；Asahi Intecc）是最常使用的导丝，而 Corsair（21%；Asahi Intecc）和 Turnpike Spiral（20%；Vascular Solutions）是最常使用的微导管。在逆行病例中，Sion（32%；Asahi Intecc）是最常用的导丝，其次是 Sion Black（22%；Asahi Intecc）、Pilot 200（22%）和 Suoh 03（19%；Asahi Intecc），而 Corsair（16%）和 Turnpike LP（11%）是最常使用的微导管。用于侧支交叉的最成功导丝是 Sion（32%），其次是 Sion Black（15%）和 Suoh 03（11%）。