title: Contemporary retrograde approach for the recanalisation of coronary chronic total occlusion: on behalf of the Japanese Retrograde Summit Group.
abstract: OBJECTIVE
  The retrograde approach to CTO is promising, but questions remain with regard to its wider application and the potential risks. This study evaluated the feasibility and efficacy of retrograde recanalisation of chronic total occlusion (CTO) of the coronary arteries.
  
  
  RESULTS
  A total of 378 consecutive patients (previously failed PCI 32.0%) who enrolled in 27 institutions in Japan underwent retrograde recanalisation for CTO. We analysed the data on lesion characteristics, procedural materials, technique used, complications and clinical outcomes. Successful retrograde recanalisation was achieved in 70.4% and the overall procedural success was 83.6%. Collateral crossing was achieved via a septal route in 68.9%, epicardial in 27.2% and bypass grafts in 2.6%, respectively. The retrograde approach was completed with implementation of reverse CART in 42.5%, direct wire crossing in 23.1%, bilateral wiring in 22.7%, and CART in 11.7%. Major and minor collateral injuries and coronary perforations were noted in 1.3%, 10.3% and 2.9% of cases, respectively. Stroke occurred in 0.3%, QWMI and emergency PCI in 0.3% of patients with successful recanalisation.
  
  
  CONCLUSIONS
  Wider application of retrograde CTO PCI achieved a high rate of success in recanalisation with an acceptable rate of complications in Japan.
authors: Department of Cardiology, Sayama Hospital, Saitama, Japan. masahisa-yamane@sayamahp.org
authors: Masahisa
authors: M
authors: Yamane
authors: Makoto
authors: M
authors: Muto
authors: Tetsuo
authors: T
authors: Matsubara
authors: Shigeru
authors: S
authors: Nakamura
authors: Toshiya
authors: T
authors: Muramatsu
authors: Akitsugu
authors: A
authors: Oida
authors: Yasumi
authors: Y
authors: Igarashi
authors: Yoichi
authors: Y
authors: Nozaki
authors: Mikihiro
authors: M
authors: Kijima
authors: Etsuo
authors: E
authors: Tuschikane
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D002908:Chronic Disease; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000000981:diagnostic imaging / Q000628:therapy*; D003331:Coronary Vessels / Q000293:injuries; D005240:Feasibility Studies; D005260:Female; D006335:Heart Injuries / Q000209:etiology; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D020521:Stroke / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000209:etiology