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Microcatheter collateral channel tracking failure in retrograde percutaneous coronary intervention for chronic total occlusion: incidence, predictors, and management. 2019

Xin Zhong, and Lei Ge, and Jianying Ma, and Dong Huang, and Kang Yao, and Feng Zhang, and Hao Lu, and Yan Yan, and Zheyong Huang, and Juying Qian, and Junbo Ge
Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China.

OBJECTIVE This study sought to demonstrate the incidence, predictors, and management of microcatheter collateral channel (CC) tracking failure in retrograde percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) lesions. RESULTS Prospectively collected data from 371 consecutive retrograde CTO-PCI procedures between March 2015 and January 2018 were retrospectively analysed. The incidence of initial microcatheter CC tracking failure was 22.5% in 280 procedures with wire CC tracking success. For septal collaterals, CC grade 0-1 collaterals (odds ratio [OR]: 8.3; p<0.001), channel entry angle <90° (OR: 13.0; p=0.001), channel exit angle <90° (OR: 44.3; p=0.004), and Finecross MG as initial microcatheter (OR: 2.7; p=0.032) were independently related to initial microcatheter CC tracking failure. Meanwhile, the only predictor for epicardial collaterals was CC 1 collaterals (OR: 26.9; p<0.001). Frequently applied solutions included microcatheter switching (61.9%), and microcatheter switching combined with GUIDEZILLA (14.3%) or anchoring balloon technique (6.3%). CONCLUSIONS Initial microcatheter CC tracking failure was found in nearly one quarter of procedures after wire CC tracking success. Independent angiographic predictors of initial microcatheter CC tracking failure included CC 0-1 collaterals, channel entry angle <90°, and channel exit angle <90° for septal collaterals, and CC 1 collaterals for epicardial collaterals.

UI MeSH Term Description Entries
D002908 Chronic Disease Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2). Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic
D003097 Collateral Circulation Maintenance of blood flow to an organ despite obstruction of a principal vessel. Blood flow is maintained through small vessels. Blood Circulation, Collateral,Circulation, Collateral,Collateral Blood Circulation,Collateral Circulation, Blood,Blood Collateral Circulation,Circulation, Blood Collateral,Circulation, Collateral Blood,Collateral Blood Circulations,Collateral Circulations,Collateral Circulations, Blood
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D015906 Angioplasty, Balloon, Coronary Dilation of an occluded coronary artery (or arteries) by means of a balloon catheter to restore myocardial blood supply. Angioplasty, Coronary Balloon,Angioplasty, Transluminal, Percutaneous Coronary,Coronary Angioplasty, Transluminal Balloon,Percutaneous Transluminal Coronary Angioplasty,Balloon Dilation, Coronary Artery,Transluminal Coronary Balloon Dilation,Angioplasties, Coronary Balloon,Balloon Angioplasties, Coronary,Balloon Angioplasty, Coronary,Coronary Balloon Angioplasties,Coronary Balloon Angioplasty
D015994 Incidence The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases in the population at a given time. Attack Rate,Cumulative Incidence,Incidence Proportion,Incidence Rate,Person-time Rate,Secondary Attack Rate,Attack Rate, Secondary,Attack Rates,Cumulative Incidences,Incidence Proportions,Incidence Rates,Incidence, Cumulative,Incidences,Person time Rate,Person-time Rates,Proportion, Incidence,Rate, Attack,Rate, Incidence,Rate, Person-time,Rate, Secondary Attack,Secondary Attack Rates
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D017023 Coronary Angiography Radiography of the vascular system of the heart muscle after injection of a contrast medium. Angiography, Coronary,Angiographies, Coronary,Coronary Angiographies
D054059 Coronary Occlusion Complete blockage of blood flow through one of the CORONARY ARTERIES, usually from CORONARY ATHEROSCLEROSIS. Coronary Occlusions,Occlusion, Coronary,Occlusions, Coronary
D062645 Percutaneous Coronary Intervention A family of percutaneous techniques that are used to manage CORONARY OCCLUSION, including standard balloon angioplasty (PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY), the placement of intracoronary STENTS, and atheroablative technologies (e.g., ATHERECTOMY; ENDARTERECTOMY; THROMBECTOMY; PERCUTANEOUS TRANSLUMINAL LASER ANGIOPLASTY). PTCA was the dominant form of PCI, before the widespread use of stenting. Percutaneous Coronary Revascularization,Coronary Intervention, Percutaneous,Coronary Interventions, Percutaneous,Coronary Revascularization, Percutaneous,Coronary Revascularizations, Percutaneous,Intervention, Percutaneous Coronary,Interventions, Percutaneous Coronary,Percutaneous Coronary Interventions,Percutaneous Coronary Revascularizations,Revascularization, Percutaneous Coronary,Revascularizations, Percutaneous Coronary

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