Table 3.
Angiographic Characteristics and Outcomes According to Retrograde Sequence
| Variable | Primary retrograde n = 248 (46%) |
Retrograde after antegrade failure n =291 (54%) |
p |
|---|---|---|---|
| Target Vessel | |||
| RCA (%) | 73.0 | 64.0 | 0.088 |
| LCX (%) | 15.2 | 19.3 | |
| LAD (%) | 11.8 | 16.7 | |
| CTO length (mm)* | 42.5 (30–70) | 30.0 (20–50) | <0.001 |
| Interventional collaterals (%) | 84.5 | 73.3 | 0.007 |
| Proximal cap ambiguity (%) | 58.3 | 38.1 | <0.001 |
| Moderate/severe tortuosity (%) | 40.3 | 42.1 | 0.677 |
| Moderate/severe calcification (%) | 69.2 | 70.2 | 0.802 |
| Poor distal target vessel (%) | 56.8 | 47.8 | 0.069 |
| In-stent restenosis (%) | 12.8 | 14.0 | 0.681 |
| Prior-failed CTO PCI (%) | 25.6 | 16.1 | 0.007 |
| J-CTO score* | 3.3±0.9 | 2.9±1.1 | <0.001 |
| Collaterals used | |||
| Septal (%) | 57.3 | 53.3 | 0.353 |
| Epicardial (%) | 34.7 | 30.6 | 0.312 |
| LIMA (%) | 2.4 | 2.1 | 0.779 |
| SVG (%) | 13.3 | 13.8 | 0.882 |
| Collateral crossing | |||
| Wire (%) | 82.5 | 68.7 | <0.001 |
| Sion† (%) | 65.3 | 71.5 | |
| Fielder FC/XT† (%) | 17.8 | 19.5 | 0.179 |
| Other (%) | 17.0 | 8.9 | |
| Microcatheter (%) | 78.7 | 66.9 | 0.004 |
| Corsair† (%) | 93.5 | 82.4 | |
| Other (%) | 6.5 | 17.6 | |
| Externalization (%) | 66.1 | 54.9 | 0.030 |
| CTO wiring technique | |||
| Reverse CART (%) | 66.1 | 58.0 | |
| Retrograde true lumen crossing (%) |
17.8 | 20.4 | 0.313 |
| Retrograde wire as marker (%) | 1.7 | 4.9 | |
| CART (%) | 1.7 | 3.7 | |
| Guideliner‡ rCART (%) | 1.2 | 2.5 | |
| Other/missing (%) | 11.5 | 10.5 | |
| Procedure time (mins)* | 170 (112 –236) | 187 (142–234) | 0.023 |
| Contrast volume (ml)* | 260 (200–375) | 343 (250–440) | <0.001 |
| Patient air kerma radiation dose (Gray)* |
4.7 (2.5–6.2) | 5.0 (3.2–6.9) | 0.089 |
| Technical success (%) | 85.5 | 84.2 | 0.677 |
| Retrograde (%) | 82.1 | 66.1 | |
| Antegrade wire escalation (%) | 6.1 | 11.0 | <0.001 |
| Antegrade dissection/re-entry (%) | 11.8 | 22.9 | |
| Procedural success (%) | |||
| MACE (%) | 84.4 | 79.9 | 0.179 |
| 3.6 | 4.8 | 0.499 | |
CART, controlled antegrade and retrograde tracking; CTO, chronic total occlusion; LAD, left anterior descending artery; LCX, left circumflex artery; LIMA, left internal mammary artery; MACE, major adverse cardiovascular events; MI, myocardial infarction; PCI, percutaneous coronary intervention; RCA, right coronary artery; SVG, saphenous vein graft.
*
mean±standard deviation or median (interquartile range).
†
Asahi Intecc, Nagoya, Japan,
‡
Vascular Solutions, Minneapolis, MN