Reclassification of CTO crossing strategies in the ERCTO registry according to the CTO-ARC consensus recommendations
Background - The CTO-ARC (Chronic Total Occlusion Academic Research Consortium) recognized that a nonstandardized definition of chronic total occlusion (CTO) percutaneous coronary intervention approaches can bias the complications’ attribution to each crossing strategy. - Objectives - The study soug...
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
28 October 2024
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| In: |
JACC Cardiovascular interventions
Year: 2024, Volume: 17, Issue: 20, Pages: 2425-2437 |
| ISSN: | 1876-7605 |
| DOI: | 10.1016/j.jcin.2024.09.002 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.jcin.2024.09.002 Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S1936879824011695 
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| Author Notes: | Giuseppe Vadalà, MD, Kambis Mashayekhi, MD, PH D, Marouane Boukhris, MD, Michael Behnes, MD, PHD, Stylianos Pyxaras, MD, PHD, Evald Høj Christiansen, MD, PH D, Juan Luis Gutiérrez-Chico, MD, P HD, Laura Maniscalco, PHD, Sinisa Stojkovic, MD, P HD, Nenad Z. Bozinovic, MD, Nicolaus Boudou, MD, Roberto Garbo, MD, Gerald S. Werner, MD, PHD, Alexander Avran, MD, Gabriele L. Gasparini, MD, Eugenio La Scala, MD, Andrew Ladwiniec, MD, George Sianos, MD, Omer Goktekin, MD, PHD, Sevket Gorgulu, MD, Pierfrancesco Agostoni, MD, Sudhir Rathore, MD, Mohamed Ayoub, MD, Roberto Diletti, MD, Carlo di Mario, MD, Josko Bulum, MD, PhD, Alfredo R. Galassi, MD, the EURO CTO Investigators |
MARC
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| 245 | 1 | 0 | |a Reclassification of CTO crossing strategies in the ERCTO registry according to the CTO-ARC consensus recommendations |c Giuseppe Vadalà, MD, Kambis Mashayekhi, MD, PH D, Marouane Boukhris, MD, Michael Behnes, MD, PHD, Stylianos Pyxaras, MD, PHD, Evald Høj Christiansen, MD, PH D, Juan Luis Gutiérrez-Chico, MD, P HD, Laura Maniscalco, PHD, Sinisa Stojkovic, MD, P HD, Nenad Z. Bozinovic, MD, Nicolaus Boudou, MD, Roberto Garbo, MD, Gerald S. Werner, MD, PHD, Alexander Avran, MD, Gabriele L. Gasparini, MD, Eugenio La Scala, MD, Andrew Ladwiniec, MD, George Sianos, MD, Omer Goktekin, MD, PHD, Sevket Gorgulu, MD, Pierfrancesco Agostoni, MD, Sudhir Rathore, MD, Mohamed Ayoub, MD, Roberto Diletti, MD, Carlo di Mario, MD, Josko Bulum, MD, PhD, Alfredo R. Galassi, MD, the EURO CTO Investigators |
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| 500 | |a Gesehen am 26.03.2025 | ||
| 520 | |a Background - The CTO-ARC (Chronic Total Occlusion Academic Research Consortium) recognized that a nonstandardized definition of chronic total occlusion (CTO) percutaneous coronary intervention approaches can bias the complications’ attribution to each crossing strategy. - Objectives - The study sought to describe the numbers, efficacy, and safety of each final CTO crossing strategy according to CTO-ARC recommendations. - Methods - In this cross-sectional study, data were retrieved from the European Registry of Chronic Total Occlusions between 2021 and 2022. - Results - Out of 8,673 patients, antegrade and retrograde approach were performed in 79.2% and 20.8% of cases, respectively. The antegrade approach included antegrade wiring and antegrade dissection and re-entry, both performed with or without retrograde contribution (antegrade wiring without retrograde contribution: n = 5,929 [68.4%]; antegrade wiring with retrograde contribution: n = 446 [5.1%]; antegrade dissection and re-entry without retrograde contribution: n = 353 [4.1%]; antegrade dissection and re-entry with retrograde contribution: n = 137 [1.6%]). The retrograde approach included retrograde wiring (n = 735 [8.4%]) and retrograde dissection and re-entry (n = 1,073 [12.4%]). Alternative antegrade crossing was associated with lower technical success (70% vs 86% vs 93.1%, respectively; P < 0.001) and higher complication rates (4.6% vs 2.9% vs 1%, respectively; P < 0.001) as compared with retrograde and true antegrade crossing. However, alternative antegrade crossing was applied mostly as a rescue strategy (96.1%). - Conclusions - The application of CTO-ARC definitions allowed the reclassification of 6.7% of procedures as alternative antegrade crossing with retrograde or antegrade contribution which showed higher MACCE and lower technical success rates, as compared with true antegrade and retrograde crossing. | ||
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| 650 | 4 | |a chronic total occlusions percutaneous coronary intervention | |
| 650 | 4 | |a CTO PCI | |
| 650 | 4 | |a CTO PCI complications | |
| 650 | 4 | |a CTO-ARC | |
| 650 | 4 | |a retrograde approach | |
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