Incidence, Predictors, and Strategies for Failure of Retrograde Microcatheter Tracking After Successful Wiring of Septal Collateral Channels in Chronic Total Occlusions

Yong Wang, Xiao-jiao Zhang, Hong-wei Zhao, Chengfu Wang, Defeng Luo, Qingkun Meng, Yu Zhu, Jie Tao, Baojun Chen, Yi Li, Aijie Hou, Bo Luan Department of Cardiology, The People’s Hospital of China Medical University, The People’s Hospital of Liaoning Province, Shenyang City, Liaon...

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Autores principales:	Wang Y, Zhang XJ, Zhao H, Wang C, Luo D, Meng Q, Zhu Y, Tao J, Chen B, Li Y, Hou A, Luan B
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	coronary chronic total occlusion retrograde microcatheter tracking collateral channel predictor Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/fbd0165324cf462ca9026edc45e8201b
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spelling	oai:doaj.org-article:fbd0165324cf462ca9026edc45e8201b2021-12-02T05:30:01ZIncidence, Predictors, and Strategies for Failure of Retrograde Microcatheter Tracking After Successful Wiring of Septal Collateral Channels in Chronic Total Occlusions1178-1998https://doaj.org/article/fbd0165324cf462ca9026edc45e8201b2020-09-01T00:00:00Zhttps://www.dovepress.com/incidence-predictors-and-strategies-for-failure-of-retrograde-microcat-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Yong Wang, Xiao-jiao Zhang, Hong-wei Zhao, Chengfu Wang, Defeng Luo, Qingkun Meng, Yu Zhu, Jie Tao, Baojun Chen, Yi Li, Aijie Hou, Bo Luan Department of Cardiology, The People’s Hospital of China Medical University, The People’s Hospital of Liaoning Province, Shenyang City, Liaoning Province 110016, People’s Republic of ChinaCorrespondence: Bo Luan; Aijie HouDepartment of Cardiology, The People’s Hospital of China Medical University, The People’s Hospital of Liaoning Province, No. 33, Wenyi Road, Shenhe District, Shenyang City, Liaoning Province 110016, People’s Republic of ChinaTel +86-17702488970Email luanbo2016@163.com; 1758624242@qq.comBackground: Retrograde microcatheter collateral channel (CC) tracking after successful wiring of septal CC is crucial for retrograde revascularization of coronary chronic total occlusion (CTO). However, the incidence, predictors, and strategies for failure of retrograde microcatheter CC tracking after successful wiring of septal CC remain unclear.Methods: In total, 298 patients with CTO who underwent retrograde septal CC PCI between January 2015 and May 2019 were retrospectively analyzed. Clinical data were compared to investigate the predictors of initial microcatheter tracking failure.Results: The initial and final microcatheter tracking success rates were 79.2% (236/298) and 96.6% (288/298), respectively. The procedural success rate was 94.0% (280/298). The right coronary artery-to-left anterior descending artery septal ratio (48.4% vs 33.1%, p=0.037) and CC tortuosity (34.6% vs 20.8%, p=0.045) were significantly higher in the initial microcatheter CC tracking failure group than in the successful tracking group. Multivariate logistic regression analysis revealed that severe collateral tortuosity (odds ratio [OR]: 13.241, 95% confidence interval [CI]: 3.429– 27.057, p=0.038), CC entry angle of < 90° (OR:4.921, 95% CI: 1.128– 9.997, p=0.002), CC exit angle of < 90° (OR:5.037, 95% CI: 2.237– 11.182, p=0.004), use of Finecross MG as initial microcatheter (OR:1.826, 95% CI: 1.127– 3.067, p=0.035), and shunning initial retrograde application of Guidezilla (OR:0.321, 95% CI: 0.267– 0.915, p=0.024) were variables independently associated with initial microcatheter CC tracking failure in patients with CTO undergoing retrograde septal CC PCI.Conclusion: The overall initial microcatheter CC tracking failure was 20.8%. Severecollateral tortuosity, CC entry, and exit angle of < 90°, use of Finecross MG as initial microcatheter, and shunning initial retrograde application of Guidezilla were variables independently associated with initial microcatheter CC tracking failure in patients with CTO undergoing retrograde septal PCI.Keywords: coronary chronic total occlusion, retrograde microcatheter tracking, collateral channel, predictorWang YZhang XJZhao HWang CLuo DMeng QZhu YTao JChen BLi YHou ALuan BDove Medical Pressarticlecoronary chronic total occlusionretrograde microcatheter trackingcollateral channelpredictorGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 15, Pp 1727-1735 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	coronary chronic total occlusion retrograde microcatheter tracking collateral channel predictor Geriatrics RC952-954.6
spellingShingle	coronary chronic total occlusion retrograde microcatheter tracking collateral channel predictor Geriatrics RC952-954.6 Wang Y Zhang XJ Zhao H Wang C Luo D Meng Q Zhu Y Tao J Chen B Li Y Hou A Luan B Incidence, Predictors, and Strategies for Failure of Retrograde Microcatheter Tracking After Successful Wiring of Septal Collateral Channels in Chronic Total Occlusions
description	Yong Wang, Xiao-jiao Zhang, Hong-wei Zhao, Chengfu Wang, Defeng Luo, Qingkun Meng, Yu Zhu, Jie Tao, Baojun Chen, Yi Li, Aijie Hou, Bo Luan Department of Cardiology, The People’s Hospital of China Medical University, The People’s Hospital of Liaoning Province, Shenyang City, Liaoning Province 110016, People’s Republic of ChinaCorrespondence: Bo Luan; Aijie HouDepartment of Cardiology, The People’s Hospital of China Medical University, The People’s Hospital of Liaoning Province, No. 33, Wenyi Road, Shenhe District, Shenyang City, Liaoning Province 110016, People’s Republic of ChinaTel +86-17702488970Email luanbo2016@163.com; 1758624242@qq.comBackground: Retrograde microcatheter collateral channel (CC) tracking after successful wiring of septal CC is crucial for retrograde revascularization of coronary chronic total occlusion (CTO). However, the incidence, predictors, and strategies for failure of retrograde microcatheter CC tracking after successful wiring of septal CC remain unclear.Methods: In total, 298 patients with CTO who underwent retrograde septal CC PCI between January 2015 and May 2019 were retrospectively analyzed. Clinical data were compared to investigate the predictors of initial microcatheter tracking failure.Results: The initial and final microcatheter tracking success rates were 79.2% (236/298) and 96.6% (288/298), respectively. The procedural success rate was 94.0% (280/298). The right coronary artery-to-left anterior descending artery septal ratio (48.4% vs 33.1%, p=0.037) and CC tortuosity (34.6% vs 20.8%, p=0.045) were significantly higher in the initial microcatheter CC tracking failure group than in the successful tracking group. Multivariate logistic regression analysis revealed that severe collateral tortuosity (odds ratio [OR]: 13.241, 95% confidence interval [CI]: 3.429– 27.057, p=0.038), CC entry angle of < 90° (OR:4.921, 95% CI: 1.128– 9.997, p=0.002), CC exit angle of < 90° (OR:5.037, 95% CI: 2.237– 11.182, p=0.004), use of Finecross MG as initial microcatheter (OR:1.826, 95% CI: 1.127– 3.067, p=0.035), and shunning initial retrograde application of Guidezilla (OR:0.321, 95% CI: 0.267– 0.915, p=0.024) were variables independently associated with initial microcatheter CC tracking failure in patients with CTO undergoing retrograde septal CC PCI.Conclusion: The overall initial microcatheter CC tracking failure was 20.8%. Severecollateral tortuosity, CC entry, and exit angle of < 90°, use of Finecross MG as initial microcatheter, and shunning initial retrograde application of Guidezilla were variables independently associated with initial microcatheter CC tracking failure in patients with CTO undergoing retrograde septal PCI.Keywords: coronary chronic total occlusion, retrograde microcatheter tracking, collateral channel, predictor
format	article
author	Wang Y Zhang XJ Zhao H Wang C Luo D Meng Q Zhu Y Tao J Chen B Li Y Hou A Luan B
author_facet	Wang Y Zhang XJ Zhao H Wang C Luo D Meng Q Zhu Y Tao J Chen B Li Y Hou A Luan B
author_sort	Wang Y
title	Incidence, Predictors, and Strategies for Failure of Retrograde Microcatheter Tracking After Successful Wiring of Septal Collateral Channels in Chronic Total Occlusions
title_short	Incidence, Predictors, and Strategies for Failure of Retrograde Microcatheter Tracking After Successful Wiring of Septal Collateral Channels in Chronic Total Occlusions
title_full	Incidence, Predictors, and Strategies for Failure of Retrograde Microcatheter Tracking After Successful Wiring of Septal Collateral Channels in Chronic Total Occlusions
title_fullStr	Incidence, Predictors, and Strategies for Failure of Retrograde Microcatheter Tracking After Successful Wiring of Septal Collateral Channels in Chronic Total Occlusions
title_full_unstemmed	Incidence, Predictors, and Strategies for Failure of Retrograde Microcatheter Tracking After Successful Wiring of Septal Collateral Channels in Chronic Total Occlusions
title_sort	incidence, predictors, and strategies for failure of retrograde microcatheter tracking after successful wiring of septal collateral channels in chronic total occlusions
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/fbd0165324cf462ca9026edc45e8201b
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Incidence, Predictors, and Strategies for Failure of Retrograde Microcatheter Tracking After Successful Wiring of Septal Collateral Channels in Chronic Total Occlusions

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