title: Initial experience of retrograde wire approach in coronary chronic total occlusion intervention.
abstract: OBJECTIVE
  Retrograde wire approach has been emerged as a useful tool to enhance success rate in coronary chronic total occlusion (CTO) intervention. Therefore, we tried to report the initial experience of retrograde approach and its clinical implication on CTO intervention.
  
  
  METHODS
  From February 2007 to July 2008, retrograde approaches were performed in 28 patients with 31 CTO lesions out of 61patients. A hydrophilic coated guidewire was inserted by using microcatheter or over-the-wire (OTW) balloon through the collateral channel (septal or epicardial artery) via several strategies.
  
  
  RESULTS
  Mean age of patients was 63.4+/-11.6 years. Male and female were 20 and 8 patients, respectively. The target artery with CTO lesions included the right coronary artery (45.2%), the left anterior descending artery (51.6%), and the left circumflex artery (3.2%). The mean length of CTO lesion was 18.4+/-16.4 mm. Overall technical success rate was 64.5%. The success rate of primary attempt was 78.9%, while the success rate of immediate and secondary attempt was 41.7%. Collateral channel dissections were observed in 3 patients and no patients among these patients developed cardiac tamponade. One patient had a silent non-Q wave myocardial infarction (MI) after the procedure. One failed patient died suddenly 3 days after the procedure. After percutaneous coronary intervention (PCI) procedure, no case was performed target vessel revascularization (TVR), urgent coronary artery bypass graft (CABG), and urgent PCI.
  
  
  CONCLUSIONS
  Retrograde approach is an evolving technique to improve the success rate of CTO intervention. After the learning curve period, this technique could be the useful tool to enhance success rate in CTO intervention.
authors: Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Korea.
authors: Suk Hwan
authors: SH
authors: Chung
authors: Moo Hyun
authors: MH
authors: Kim
authors: Long Hao
authors: LH
authors: Yu
authors: Jong Sung
authors: JS
authors: Park
authors: Kyung Ho
authors: KH
authors: Kim
authors: Dong Sung
authors: DS
authors: Kum
authors: Tae Ho
authors: TH
authors: Park
authors: Kwang Soo
authors: KS
authors: Cha
authors: Young Dae
authors: YD
authors: Kim