Retrograde Chronic Total Occlusion Percutaneous Coronary Intervention via Saphenous Vein Graft

Xenogiannis, Iosif; Gkargkoulas, Fotis; Karmpaliotis, Dimitri; Krestyaninov, Oleg; Khelimskii, Dmitrii; Jaffer, Farouc A.; Khatri, Jaikirshan; Kandzari, David E.; Wyman, R. Michael; Doing, Anthony; Dattilo, Phil; Toma, Catalin; Yeh, Robert W.; Tamez, Hector; Choi, James W.; Jaber, Wissam; Samady, Habib; Sheikh, Abdul Malik; Potluri, Srinivasa; Patel, Mitul; Mahmud, Ehtisham; Elbaruni, Basem; Love, Michael P.; Koutouzis, Michalis; Tsiafoutis, Ioannis; Jefferson, Brian; Patel, Taral; Uretsky, Barry F.; Moses, Jeffrey W.; Lembo, Nicholas; Parikh, Manish; Kirtane, Ajay J.; Ali, Ziad A.; Hall, Allison B.; Megaly, Michael; Vemmou, Evangelia; Nikolakopoulos, Ilias; Rangan, Bavana V.; Morley, Pamela; Dargham, Bassel Bou; Abdullah, Shuaib; García, Santiago; Banerjee, Subhash; Burke, M. Nicholas; Brilakis, Emmanouil S.; Alaswad, Khaldoon

doi:10.1016/j.jcin.2019.10.028

Cited by 25 publications

(12 citation statements)

References 19 publications

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“…28 For appropriate interventional collaterals, the collateral channels can be septal arteries, epicardial connections but also can be graft vascular (either arterial or venous). 29 By using the backdoor to pass the guidewire from the donor artery via a collateral channel to penetrate the distal cap, the success rate of CTO-PCI has increased to >90% in the hands of CTO masters with a proper retrograde approach. 30 In our meta-analysis, the number of interventional collaterals has no significant difference between the two groups.…”

Section: Discussionmentioning

confidence: 99%

Lesion characteristics and procedural complications of chronic total occlusion percutaneous coronary intervention in patients with prior bypass surgery: A meta‐analysis

Shi

Luo

et al. 2022

Clinical Cardiology

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Coronary artery bypass graft (CABG) accelerates the prevalence of native coronary chronic total occlusion (CTO), and this kind of CTO shows extensive challenging and complex atherosclerotic pathology. As a result, the procedural success rate of percutaneous coronary intervention (PCI) is inferior to another kind of lesions. The present meta-analysis aims to compare the lesion characteristics and procedural complications of CTO-PCI in patients with or without prior CABG. A total of 8 studies, comprising of 13439 patients, published from inception to August 2021 were included in this meta-analysis. Results were pooled using random effects model and are presented as odds ratio (OR) with 95% confidence intervals (95% CIs). From the 13439 patients enrolled, 3349 (24.9%) patients had previous CABG and 10090 (75.1%) formed the control group in our analysis. For the clinical characteristic, compared to the non-CABG patients, prior CABG patients were older (OR, 3.98; 95% CI,

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Section: Discussionmentioning

confidence: 99%

Lesion characteristics and procedural complications of chronic total occlusion percutaneous coronary intervention in patients with prior bypass surgery: A meta‐analysis

Shi

Luo

et al. 2022

Clinical Cardiology

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“…The efficacy and safety of using saphenous vein grafts (SVG) for retrograde crossing during CTO PCI was explored in a study including 1615 retrograde CTO PCI. The use of the SVG for retrograde access was associated with higher rates of procedural success without differences in in-hospital MACE [63]. A comparison of available scores to predict CTO PCI success showed comparable capacity of the EuroCTO (CASTLE) and JCTO scores with a superior discriminatory capacity for CASTLE score as complexity increased [64].…”

Section: Lesion Subsetsmentioning

confidence: 94%

Acute and one-year clinical outcomes of pre-stenting intravascular ultrasound: a patient-level meta-analysis of randomised clinical trials

Hong¹,

Kim²,

Kim³

et al. 2021

EuroIntervention

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“…Nguyen [12]. The registry showed that the use of SVGs for retrograde crossing was associated with higher rates of procedural success (81% vs. 74%; p = 0.04) and no difference in inhospital major adverse cardiac events (6.4% vs. 4.4%; p = 0.22) in comparison with retrograde CTO PCI through other collaterals.…”

Section: Discussionmentioning

confidence: 97%

“…Literature on retrograde CTO recanalization through a SVG is limited [10,11]. More recently, a larger United States (U.S.) registry was published [12].…”

Section: Discussionmentioning

confidence: 99%

Algorithm for Recanalization of Chronic Totally Occluded (CTO) Native Coronary Arteries Through a Diseased or Occluded Saphenous Vein Graft in Post Bypass Patients.

Dens¹

2021

JCCI

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Chronic total occlusion (CTO) desobstruction of a native coronary artery in a post coronary artery bypass graft (CABG) patient can be a challenging procedure. In principle, the 3 basic approaches of recanalization of occluded native coronary arteries can be used: antegrade wire escalation (AWE), antegrade dissection re-entry (ADR) and a retrograde technique. On the other hand, a previous implanted saphenous vein graft (SVG) – even when occluded – can be used as a conduit for retrograde access. Moreover, access through a graft might be less complex compared to the use of septal or epicardial collaterals. If the graft is still open or has a tapered stump, this should be considered as a suitable conduit. Literature on recanalization of occluded native coronary arteries trough a diseased or occluded SVG is limited. A flowchart with an algorithm in post CABG patients is proposed and illustrated by 3 clinical cases.

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Retrograde Chronic Total Occlusion Percutaneous Coronary Intervention via Saphenous Vein Graft

Cited by 25 publications

References 19 publications

Lesion characteristics and procedural complications of chronic total occlusion percutaneous coronary intervention in patients with prior bypass surgery: A meta‐analysis

Lesion characteristics and procedural complications of chronic total occlusion percutaneous coronary intervention in patients with prior bypass surgery: A meta‐analysis

Acute and one-year clinical outcomes of pre-stenting intravascular ultrasound: a patient-level meta-analysis of randomised clinical trials

Algorithm for Recanalization of Chronic Totally Occluded (CTO) Native Coronary Arteries Through a Diseased or Occluded Saphenous Vein Graft in Post Bypass Patients.

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