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ASSA13-15-10 Analysis of 135 Cases of Retrograde Wire For the Treatment of Chronic Coronary Artery Occlusion
  1. Tian Bing,
  2. Jing Quanmin,
  3. Sui Liyou,
  4. Han Yaling,
  5. Wang Geng,
  6. Wang Bin,
  7. Ma Yingyan,
  8. Wang Xiaozeng,
  9. Liu Haiwei
  1. Department of Cardiology, Institute of Cardiovascular Research of People’s Liberation Army, Shenyang Northern Hospital

Abstract

Objective To investigate the feasibility and safety of wire technique for the treatment of chronic coronary artery occlusion.

Methods 135 patients with chronic coronary artery occlusion who received coronary artery inner bracket operations by retrograde wire technique following failure of routine transcutaneous antegrade wire technique, or estimating difficulty in the antegrade operation, were followed up last 8 years by angiography or on telephone. The data of 135 CTO patients undergoing PCI for a CTO from August 2004 were analysed. Retrograde wire technique was performed successfully in 128 patients with chronic coronary artery occlusion. The average occlusion lasts more than 3.3 years. PCI was successfully performed in 110 CTO patients with 2–3 coronary collateral blood flow circulationby author (JING) independently, including 64 LAD CTO and 76 RCA CTO. The average of 128 patients were treated by using 3.6 drug-eluting stents, 4.6 guidewires, 1.7 microcatheters and intravascular contrast media 320ML. The successful rate of guided catheter placement by right radial and right femoral approach was very high (96.4%). The successful rate of antegrade wire into regtrograde microcatheter in catheter 39.4% was higher (P < 0.05) than anterior of CTO lesion33.3% and in CTO lesion 27.3%. All the patients took the statins and antiplatelet drugs regularly once a day, were followed up 6–12 months by angiography or on telephone. The improvement rate of heart function and angina pectoris was 87.4% and 76.1%. Operative failures occurred in 7 patients owing to failure to pass through the occlusion. The locations were femoral artery pseudoaneurysm in 2 cases. Only 1 patients had reoperations due to coronary stent occlusion No major events such as death, myocardial infarction, and emergency CABG occurred. This new technique, can be used as an alternative method in establishing the antegrade guidewire channel in CTO retrograde intervention.

Results and Conclusions Conclusion method is feasibility and safety for patients. Careful evaluation on CTO lesion is a key to obtain a relatively high success rate of PCI. Retrograde wire technique significantly increases the success rate of procedure in patients who failed in antegrade wire technique. Exquisite operating and select equipment are important too. It confirmed its good effect for patients with coronary artery inner bracket operation.

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