Angiographic and clinical outcomes of antegrade versus retrograde techniques for chronic total occlusion revascularizations: Insights from the PRISON IV trial

Objectives Available data indicate mixed outcomes after using retrograde techniques for chronic total occlusion(CTO) recanalization, with generally higher need for repeat revascularization. Aim of this study is to analyze the angiographic and clinical outcome of patients treated with retrograde tech...

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Bibliographic Details
Published in:Catheterization and cardiovascular interventions 2019-02, Vol.93 (2), p.E81-E89
Main Authors: Zivelonghi, Carlo, van Andel, Mitzi, Venturi, Gabriele, Amoroso, Giovanni, Teeuwen, Koen, Tijssen, Jan G.P., Tavella, Domenico, Ribichini, Flavio, ten Berg, Jurrien M., Resning, Benno J., Henriques, José P.S., Suttorp, Maarten J., Agostoni, Pierfrancesco, Van der Schaaf, Renè J.
Format: Article
Language:English
Subjects:
Aged
Angina
Angiography
Chronic Disease
chronic total occlusion
Clinical outcomes
Coronary Angiography
Coronary Occlusion - diagnostic imaging
Coronary Occlusion - mortality
Coronary Occlusion - therapy
Demographics
Female
Humans
Implants
Lesions
Male
Medical imaging
Middle Aged
Occlusion
Percutaneous Coronary Intervention - adverse effects
Percutaneous Coronary Intervention - instrumentation
Percutaneous Coronary Intervention - methods
Percutaneous Coronary Intervention - mortality
Predictive Value of Tests
quantitative coronary analysis
Randomization
retrograde approach
Risk Factors
Stents
Time Factors
Treatment Outcome
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Summary:Objectives Available data indicate mixed outcomes after using retrograde techniques for chronic total occlusion(CTO) recanalization, with generally higher need for repeat revascularization. Aim of this study is to analyze the angiographic and clinical outcome of patients treated with retrograde techniques in the PRISON‐IV trial. Methods and Results This is a post‐hoc sub‐analysis from the randomized PRISON‐IV trial. Briefly, 330 patients with a successfully recanalized CTO lesion were randomized 1:1 to receive either hybrid‐SES or EES. The hybrid‐SES failed to reach the non‐inferiority primary endpoint of in‐segment late lumen loss at 9‐month angiography follow‐up. In the present analysis, we divided the population according to the first technical approach, namely antegrade (n = 285) or retrograde approach (n = 45). Demographic characteristics were similar between the two groups, while angiographic features disclosed higher CTO lesion complexity in the group treated with retrograde techniques (J‐CTO score: 1.8 ± 1.1 vs 2.6 ± 1.1, respectively, P 
ISSN:1522-1946
1522-726X
DOI:10.1002/ccd.27795