Angiographic success and procedural complications in patients undergoing retrograde percutaneous coronary chronic total occlusion interventions: A weighted meta-analysis of 3482 patients from 26 studies

作者：El Sabbagh Abdallah; Patel Vishal G; Jeroudi Omar M; Michael Tesfaldet T; Alomar Mohammed E; Mogabgab Owen; Fuh Eric; Roesle Michele; Rangan Bavana V; Abdullah Shuaib; Hastings Jeffrey L; Grodin Jerrold; Kumbhani Dharam J; Alexopoulos Dimitrios; Fasseas Panayotis; Banerjee Subhash; Brilakis Emmanouil S^*

来源：International Journal of Cardiology, 2014, 174(2): 243-248.

DOI：10.1016/j.ijcard.2014.04.004

• Percutaneous coronary intervention
• Chronic total occlusion
• Retrograde
• Complications
• Outcomes

Background: The efficacy and safety profile of retrograde chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. We sought to perform a weighted meta-analysis of the success and complication rates of retrograde CTO PCI. %26lt;br%26gt;Methods: We conducted a meta-analysis of 26 studies published between 2006 and April 2013 reporting in-hospital outcomes of retrograde CTO PCI. Data on procedural success, frequency of death, emergent coronary artery bypass graft surgery (CABG), stroke, myocardial infarction (MI), perforation, tamponade, stent thrombosis, major vascular or bleeding events, contrast nephropathy, and radiation skin injury were collected. %26lt;br%26gt;Results: A total of 26 studies with 3482 patients and 3493 target CTO lesions were included. Primary retrograde CTO PCI was attempted in 52.4%. Pooled estimates of outcomes were as follows: procedural success 83.3% [95% confidence interval (CI): 79.0% to 87.7%]; death 0.7% (95% CI: 0.5% to 1.2%); urgent CABG 0.7% (95% CI: 0.4% to 1.2%); tamponade 1.4% (95% CI: 1.0% to 2.2%); collateral perforation 6.9% (95% CI: 4.6% to 10.4%); coronary perforation 4.3% (95% CI: 1.2% to 15.4%); donor vessel dissection 2% (95% CI: 0.9% to 4.5%); stroke 0.5% (95% CI: 0.2% to 1.0%); MI 3.1% (95% CI: 0.2% to 5.0%); Q wave MI 0.6% (95% CI: 0.4% to 1.1%); vascular access complications 2% (95% CI: 0.9% to 4.5%); contrast nephropathy 1.8% (95% CI: 0.8% to 3.7%); and wire fracture and equipment entrapment 1.2% (95% CI: 0.6% to 2.5%). %26lt;br%26gt;Conclusions: Retrograde CTO PCI is associated with high procedural success rate and acceptable risk for procedural complications. Published by Elsevier Ireland Ltd.

• 出版日期2014-6-15