Japanese multicenter registry evaluating the antegrade dissection reentry with cardiac computerized tomography for chronic coronary total occlusion

Recently, antegrade dissection re-entry (ADR) with re-entry device for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has evolved to become one of the pillar techniques of the hybrid algorithm. Although the success rate of the device is high, it could be improved. We sought t...

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Bibliographic Details
Published in:Cardiovascular intervention and therapeutics 2022-01, Vol.37 (1), p.116-127
Main Authors: Habara, Maoto, Tsuchikane, Etsuo, Shimizu, Kazuki, Kashima, Yoshifumi, Shimoji, Kenichiro, Nakamura, Shigeru, Niizeki, Takeshi, Tsutsumi, Takaki, Ito, Yoshiaki, Kawasaki, Tomohiro
Format: Article
Language:English
Subjects:
Cardiology
Chronic Disease
Computed Tomography Angiography
Coronary Angiography
Coronary Occlusion - diagnosis
Coronary Occlusion - surgery
Dissection
Humans
Interventional Radiology
Japan
Medicine
Medicine & Public Health
Original
Original Article
Percutaneous Coronary Intervention
Registries
Risk Factors
Treatment Outcome
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Summary:Recently, antegrade dissection re-entry (ADR) with re-entry device for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has evolved to become one of the pillar techniques of the hybrid algorithm. Although the success rate of the device is high, it could be improved. We sought to evaluate the current trends and issues associated with ADR in Japan and evaluate the potential of cardiac computed tomography angiography (CCTA) for ADR procedure. A total 48 patients with CTO suitable for ADR evaluated by baseline conventional angiography and CCTA were enrolled. Procedural success and technical success were evaluated as the primary and secondary observations. Furthermore, all puncture points were analyzed by CCTA. CT score at each punctured site depended on the location of plaque deposition (none; + 0, at isolated myocardial site; + 1, at epicardial site; + 2) and the presence of calcification (none; + 0, presence; + 1) was analyzed and calculated (score 0–3). Overall procedure success rate was 95.8%. Thirty-two cases were attempted with the ADR procedure and 25 cases of them were successful. The technical success rate was 78.1% and myocardial infarction or other major complications were not observed in any cases. CT score at 60 puncture sites in 32 cases were analyzed and the score at technical success points was significantly smaller compared to that at technical failure points (0.68 ± 1.09 vs 1.77 ± 1.09, p  
ISSN:1868-4300
1868-4297
DOI:10.1007/s12928-021-00762-x