title: Comparison of percutaneous coronary intervention for chronic total occlusion outcome according to operator experience from the Japanese retrograde summit registry.
abstract: OBJECTIVE
  This study was performed to evaluate the acute outcomes of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) based on operator experience.
  
  
  BACKGROUND
  Despite developments in both technology and techniques, PCI procedures for CTO's remain challenging.
  
  
  METHODS
  A total of 3,229 eligible subjects who underwent CTO-PCI were enrolled from 56 centers by a retrograde summit using a web registry system. To compare the acute outcomes of the CTO data, 18 centers were classified as higher volume centers (HC) and 38 centers as lower volume centers (LC) depending on the CTO-PCI experience of the operator.
  
  
  RESULTS
  The mean procedural success rate of all centers was 88.4%. The overall procedural success rate was significantly higher in HC than LC (90.6% vs. 85.6%, respectively; P < 0.0001). In addition, overall antegrade success rate was also higher in HC than LC (91.0% vs. 83.9%, respectively; P < 0.0001). Although the overall retrograde approach success rate was significantly higher in HC than LC (85.0% vs. 77.6%, respectively; P < 0.0001), there was no significant difference in that of the retrograde alone (89.0% vs. 93.7%, respectively; P = 0.051). Major in-hospital adverse events were observed in 0.53% of cases, and the rates were similar between the two groups (0.45% vs. 0.62%, respectively; P = 0.25).
  
  
  CONCLUSIONS
  Although CTO-PCI was safe in both groups, the procedural success rate was significantly higher in HC than LC, even in this new era of CTO-PCI. This difference was attributed to the difference in the antegrade procedural success rate. © 2015 Wiley Periodicals, Inc.
authors.affiliation: Department of Cardiovascular Medicine, Toyohashi Heart Center, Aichi, Japan.
authors.forename: Maoto
authors.initials: M
authors.lastname: Habara
authors.affiliation: Department of Cardiovascular Medicine, Toyohashi Heart Center, Aichi, Japan.
authors.forename: Etsuo
authors.initials: E
authors.lastname: Tsuchikane
authors.affiliation: Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Kanagawa, Japan.
authors.forename: Toshiya
authors.initials: T
authors.lastname: Muramatsu
authors.affiliation: Division of Cardiology, Sapporo CardioVascular Clinic, Hokkaido, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Kashima
authors.affiliation: Division of Cardiology, Sakurabashi-Watanabe Hospital, Osaka, Japan.
authors.forename: Atsunori
authors.initials: A
authors.lastname: Okamura
authors.affiliation: Division of Cardiology, Saitama Prefecture Cardiovascular and Respiratory Center, Saitama, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Mutoh
authors.affiliation: Cardiology Department, Saitama Sekishinkai Hospital, Saitama, Japan.
authors.forename: Masahisa
authors.initials: M
authors.lastname: Yamane
authors.affiliation: Department of Cardiology, Takase Clinic, Gunma, Japan.
authors.forename: Akitsugu
authors.initials: A
authors.lastname: Oida
authors.affiliation: Department of Cardiovascular, the Cardiovascular Institute, Tokyo, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Oikawa
authors.affiliation: Division of Cardiology, Higashi Takarazuka Satoh Hospital, Osaka, Japan.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Hasegawa
mesh_terms: D000368:Aged; D002908:Chronic Disease; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011446:Prospective Studies; D012372:ROC Curve; D012042:Registries; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
keywords: antegrade approach; chronic total occlusion; retrograde approach