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Retrograde Chronic Total Occlusion Percutaneous Coronary Intervention via Saphenous Vein Graft.
JACC: Cardiovascular Interventions ( IF 11.7 ) Pub Date : 2020-02-24 , DOI: 10.1016/j.jcin.2019.10.028 Iosif Xenogiannis 1 , Fotis Gkargkoulas 2 , Dimitri Karmpaliotis 2 , Oleg Krestyaninov 3 , Dmitrii Khelimskii 3 , Farouc A Jaffer 4 , Jaikirshan J Khatri 5 , David E Kandzari 6 , R Michael Wyman 7 , Anthony H Doing 8 , Phil Dattilo 8 , Catalin Toma 9 , Robert W Yeh 10 , Hector Tamez 10 , James W Choi 11 , Wissam Jaber 12 , Habib Samady 12 , Abdul M Sheikh 13 , Srinivasa Potluri 14 , Mitul Patel 15 , Ehtisham Mahmud 15 , Basem Elbaruni 16 , Michael P Love 16 , Michalis Koutouzis 17 , Ioannis Tsiafoutis 17 , Brian K Jefferson 18 , Taral Patel 18 , Barry Uretsky 19 , Jeffrey W Moses 2 , Nicholas J Lembo 2 , Manish Parikh 2 , Ajay J Kirtane 2 , Ziad A Ali 2 , Allison B Hall 1 , Michael S Megaly 1 , Evangelia Vemmou 1 , Ilias Nikolakopoulos 1 , Bavana V Rangan 1 , Pamela W Morley 1 , Bassel Bou Dargham 20 , Shuaib Abdullah 20 , Santiago Garcia 1 , Subhash Banerjee 20 , M Nicholas Burke 1 , Emmanouil S Brilakis 1 , Khaldoon Alaswad 21
JACC: Cardiovascular Interventions ( IF 11.7 ) Pub Date : 2020-02-24 , DOI: 10.1016/j.jcin.2019.10.028 Iosif Xenogiannis 1 , Fotis Gkargkoulas 2 , Dimitri Karmpaliotis 2 , Oleg Krestyaninov 3 , Dmitrii Khelimskii 3 , Farouc A Jaffer 4 , Jaikirshan J Khatri 5 , David E Kandzari 6 , R Michael Wyman 7 , Anthony H Doing 8 , Phil Dattilo 8 , Catalin Toma 9 , Robert W Yeh 10 , Hector Tamez 10 , James W Choi 11 , Wissam Jaber 12 , Habib Samady 12 , Abdul M Sheikh 13 , Srinivasa Potluri 14 , Mitul Patel 15 , Ehtisham Mahmud 15 , Basem Elbaruni 16 , Michael P Love 16 , Michalis Koutouzis 17 , Ioannis Tsiafoutis 17 , Brian K Jefferson 18 , Taral Patel 18 , Barry Uretsky 19 , Jeffrey W Moses 2 , Nicholas J Lembo 2 , Manish Parikh 2 , Ajay J Kirtane 2 , Ziad A Ali 2 , Allison B Hall 1 , Michael S Megaly 1 , Evangelia Vemmou 1 , Ilias Nikolakopoulos 1 , Bavana V Rangan 1 , Pamela W Morley 1 , Bassel Bou Dargham 20 , Shuaib Abdullah 20 , Santiago Garcia 1 , Subhash Banerjee 20 , M Nicholas Burke 1 , Emmanouil S Brilakis 1 , Khaldoon Alaswad 21
Affiliation
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OBJECTIVES
The aim of this study was to examine the use of saphenous vein grafts (SVGs) for retrograde crossing during chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
BACKGROUND
The use of SVGs for retrograde crossing during CTO PCI has received limited study.
METHODS
A total of 1,615 retrograde CTO PCIs performed between 2012 and 2019 at 25 centers were examined. Clinical, angiographic, and technical characteristics and procedural outcomes were compared among retrograde cases via SVGs (SVG group) versus other collateral vessels (non-SVG group).
RESULTS
Retrograde CTO PCI via SVGs was performed in 189 cases (12%). Patients in the SVG group were older (mean age 70 ± 9 years vs. 64 ± 10 years; p < 0.01) and had higher rates of prior myocardial infarction (62% vs. 51%; p < 0.01) and prior PCI (81% vs. 70%; p < 0.01). They were more likely to have moderate or severe calcification (81% vs. 65%; p < 0.01) and moderate or severe tortuosity (53% vs. 44%; p = 0.02) and had similar J-CTO (Multicenter CTO Registry in Japan) scores (3.2 ± 1.0 vs. 3.1 ± 1.1; p = 0.13) but higher PROGRESS-CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) scores (4.7 ± 1.7 vs. 3.1 ± 1.1; p < 0.01). Technical (85% vs. 78%; p = 0.04) and procedural (81% vs. 74%; p = 0.04) success rates were higher in the SVG group, with no difference in in-hospital major adverse events (6.4% vs. 4.4%; p = 0.22). Contrast volume was lower in the SVG group (225 ml [173 to 325 ml] vs. 292 ml [202 to 400 ml]; p < 0.01).
CONCLUSIONS
Use of SVGs for retrograde crossing is associated with higher rates of technical and procedural success and similar rates of in-hospital major adverse cardiac events compared with retrograde CTO PCI via other collateral vessels.
中文翻译：
通过大隐静脉移植逆行慢性总闭塞经皮冠状动脉介入治疗。
目的本研究的目的是研究在慢性完全阻塞（CTO）经皮冠状动脉介入治疗（PCI）期间使用大隐静脉移植物（SVG）进行逆行穿越的情况。背景技术在CTO PCI期间使用SVG进行逆行穿越的研究受到了有限的研究。方法研究了2012年至2019年在25个中心进行的1,615个逆行CTO PCI。比较了通过SVGs（SVG组）和其他侧支血管（非SVG组）的逆行病例的临床，血管造影，技术特征和手术结局。结果189例（12％）患者通过SVG逆行CTO PCI。SVG组患者年龄较大（平均年龄70±9岁vs. 64±10岁； p <0.01），既往心肌梗死发生率更高（62％vs. 51％； p <0.01）和既往PCI（81 ％与70％； p <0。01）。他们更有可能出现中度或重度钙化（81％比65％； p <0.01）和中度或重度曲折（53％比44％； p = 0.02），并且具有相似的J-CTO（多中心CTO注册中心）日本）得分（3.2±1.0 vs. 3.1±1.1; p = 0.13），但PROGRESS-CTO（慢性总闭塞干预研究全球注册机构）得分更高（4.7±1.7 vs. 3.1±1.1; p <0.01） 。SVG组的技术成功率（85％vs. 78％; p = 0.04）和程序性成功率（81％vs. 74％; p = 0.04）较高，院内主要不良事件无差异（6.4％vs. 4.4％； p ＝ 0.22）。SVG组的造影剂体积较低（225 ml [173至325 ml]与292 ml [202至400 ml]； p <0.01）。
更新日期：2020-02-20
中文翻译：
通过大隐静脉移植逆行慢性总闭塞经皮冠状动脉介入治疗。
目的本研究的目的是研究在慢性完全阻塞（CTO）经皮冠状动脉介入治疗（PCI）期间使用大隐静脉移植物（SVG）进行逆行穿越的情况。背景技术在CTO PCI期间使用SVG进行逆行穿越的研究受到了有限的研究。方法研究了2012年至2019年在25个中心进行的1,615个逆行CTO PCI。比较了通过SVGs（SVG组）和其他侧支血管（非SVG组）的逆行病例的临床，血管造影，技术特征和手术结局。结果189例（12％）患者通过SVG逆行CTO PCI。SVG组患者年龄较大（平均年龄70±9岁vs. 64±10岁； p <0.01），既往心肌梗死发生率更高（62％vs. 51％； p <0.01）和既往PCI（81 ％与70％； p <0。01）。他们更有可能出现中度或重度钙化（81％比65％； p <0.01）和中度或重度曲折（53％比44％； p = 0.02），并且具有相似的J-CTO（多中心CTO注册中心）日本）得分（3.2±1.0 vs. 3.1±1.1; p = 0.13），但PROGRESS-CTO（慢性总闭塞干预研究全球注册机构）得分更高（4.7±1.7 vs. 3.1±1.1; p <0.01） 。SVG组的技术成功率（85％vs. 78％; p = 0.04）和程序性成功率（81％vs. 74％; p = 0.04）较高，院内主要不良事件无差异（6.4％vs. 4.4％； p ＝ 0.22）。SVG组的造影剂体积较低（225 ml [173至325 ml]与292 ml [202至400 ml]； p <0.01）。
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