Incidence, Predictors, and Strategies for Failure of Retrograde Microcatheter Tracking After Successful Wiring of Septal Collateral Channels in Chronic Total Occlusions

Retrograde microcatheter collateral channel (CC) tracking after successful wiring of septal CC is crucial for retrograde revascularization of coronary chronic total occlusion (CTO). However, the incidence, predictors, and strategies for failure of retrograde microcatheter CC tracking after successfu...

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Bibliographic Details
Published in:Clinical interventions in aging 2020-01, Vol.15, p.1727-1735
Main Authors: Wang, Yong, Zhang, Xiao-Jiao, Zhao, Hong-Wei, Wang, Chengfu, Luo, Defeng, Meng, Qingkun, Zhu, Yu, Tao, Jie, Chen, Baojun, Li, Yi, Hou, Aijie, Luan, Bo
Format: Article
Language:English
Subjects:
Aged
Arterial occlusions
Blood vessels
Cardiology
Cardiovascular disease
Care and treatment
Catheterization
Chronic Disease
collateral channel
Collateral Circulation - physiology
Complications
Complications and side effects
coronary chronic total occlusion
Coronary heart disease
Coronary Occlusion - surgery
Equipment Failure - statistics & numerical data
Female
Heart attacks
Hematoma
Humans
Incidence
Male
Medical imaging
Middle Aged
Odds Ratio
Older people
Original Research
Patients
Percutaneous Coronary Intervention - instrumentation
Percutaneous Coronary Intervention - statistics & numerical data
Population
predictor
Regression analysis
retrograde microcatheter tracking
Retrospective Studies
Statistics
Stents
Success
Surgery
Thrombosis
Treatment Outcome
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Summary:Retrograde microcatheter collateral channel (CC) tracking after successful wiring of septal CC is crucial for retrograde revascularization of coronary chronic total occlusion (CTO). However, the incidence, predictors, and strategies for failure of retrograde microcatheter CC tracking after successful wiring of septal CC remain unclear. In total, 298 patients with CTO who underwent retrograde septal CC PCI between January 2015 and May 2019 were retrospectively analyzed. Clinical data were compared to investigate the predictors of initial microcatheter tracking failure. The initial and final microcatheter tracking success rates were 79.2% (236/298) and 96.6% (288/298), respectively. The procedural success rate was 94.0% (280/298). The right coronary artery-to-left anterior descending artery septal ratio (48.4% vs 33.1%, p=0.037) and CC tortuosity (34.6% vs 20.8%, p=0.045) were significantly higher in the initial microcatheter CC tracking failure group than in the successful tracking group. Multivariate logistic regression analysis revealed that severe collateral tortuosity (odds ratio [OR]: 13.241, 95% confidence interval [CI]: 3.429-27.057, p=0.038), CC entry angle of
ISSN:1178-1998
1176-9092
1178-1998
DOI:10.2147/CIA.S263216