title: Japanese multicenter registry evaluating the retrograde approach for chronic coronary total occlusion.
abstract: OBJECTIVE
  This registry evaluated the current trends and outcomes associated with retrograde percutaneous coronary intervention (PCI) for chronic total occlusion (CTO).
  
  
  BACKGROUND
  Since its introduction, several techniques and technologies have been introduced for retrograde PCI for CTO.
  
  
  METHODS
  Eight hundred and one patients who underwent retrograde PCI for CTO in 28 Japanese centers between January 2009 and December 2010 were enrolled in this registry.
  
  
  RESULTS
  Overall procedural and clinical success rates were 84.8 and 83.8%, respectively, of which, retrograde procedures accounted for 71.2 and 70.3%, respectively. The use of channel dilators increased in 2010 compared to that in 2009 (36 vs. 95.3%, P < 0.0001), attributed improving collateral channel crossing using a wire and catheter (70.6% vs. 81.1%, P = 0.0005) and increased availability of epicardial channels (27.6% vs. 36.9%). The use of the reverse controlled antegrade and retrograde tracking technique also increased (41.9 vs. 66.5%). Although these changes decreased procedure time (203.3 min vs. 187.9 min, P = 0.024), they did not significantly improve overall procedural success rate (84.1% vs. 85.3%, P = 0.63). Multivariate analysis identified age 65 years or more and lesion calcification as unfavorable factors and the use of a channel dilator as a favorable factor for retrograde procedural success.
  
  
  CONCLUSIONS
  Increased availability of channel dilators has altered strategies for retrograde PCI for CTO. However, retrograde PCI for CTO could be improved by overcoming its main obstacle of severe calcification.
authors: Department of Cardiology, Toyohashi Heart Center, Aichi, Japan.
authors: Etsuo
authors: E
authors: Tsuchikane
authors: Masahisa
authors: M
authors: Yamane
authors: Makoto
authors: M
authors: Mutoh
authors: Tetsuo
authors: T
authors: Matsubara
authors: Tsutomu
authors: T
authors: Fujita
authors: Shigeru
authors: S
authors: Nakamura
authors: Toshiya
authors: T
authors: Muramatsu
authors: Atsunori
authors: A
authors: Okamura
authors: Yasumi
authors: Y
authors: Igarashi
authors: Akitsugu
authors: A
authors: Oida
mesh_terms: D000367:Age Factors; D000368:Aged; D062906:Cardiac Catheters; D016009:Chi-Square Distribution; D002908:Chronic Disease; D054059:Coronary Occlusion / Q000175:diagnosis / Q000628:therapy*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008904:Miniaturization; D015999:Multivariate Analysis; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D061205:Vascular Calcification / Q000175:diagnosis / Q000628:therapy
keywords: Uganda; cervical cancer; human papillomavirus; male circumcision; sexually transmitted infections; viral load; viral shedding