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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/24340

Title: Antegrade Dissection and Reentry as Part of the Hybrid Chronic Total Occlusion Revascularization Strategy A Subanalysis of the RECHARGE Registry (Registry of CrossBoss and Hybrid Procedures in France, the Netherlands, Belgium and United Kingdom)
Authors: Maeremans, Joren
Dens, Jo
Spratt, James C.
Bagnall, Alan J.
Stuijfzand, Wynand
Nap, Alexander
Agostoni, Pierfrancesco
Wilson, William
Hanratty, Colm G.
Wilson, Simon
Faurie, Benjamin
Avran, Alexandre
Bressollette, Erwan
Egred, Mohaned
Knaapen, Paul
Walsh, Simon
Issue Date: 2017
Citation: CIRCULATION-CARDIOVASCULAR INTERVENTIONS, 10(6), p. 1-9 (Art N° e004791)
Abstract: Background-Development of the CrossBoss and Stingray devices for antegrade dissection and reentry (ADR) of chronic total occlusions has improved historically suboptimal outcomes. However, the outcomes, safety, and failure modes of the technique have to be studied in a larger patient cohort. This preplanned substudy of the RECHARGE registry (Registry of CrossBoss and Hybrid Procedures in France, the Netherlands, Belgium and United Kingdom) aims to evaluate the value and use of ADR and determine its future position in contemporary chronic total occlusion intervention. Methods and Results-Patients were selected if an ADR strategy was applied. Outcomes, safety, and failure modes of the technique were assessed. The ADR technique was used in 23% (n= 292/1253) of the RECHARGE registry and was mainly applied for complex lesions (Japanese chronic total occlusion score= 2.7 +/- 1.1). ADR was the primary strategy in 30% (n= 88/292), of which 67% were successful. Bail-out ADR strategies were successful in 63% (n= 133/210). The Controlled ADR (ie, combined CrossBoss-Stingray) subtype was applied most frequently (32%; n= 93/292) and successfully (81%; n= 75/93). Overall perlesion success rate was 78% (n= 229/292), after use of additional bail-out strategies. The inability to reach the distal target zone (n= 48/100) or to reenter (n= 43/100) most commonly led to failure. ADR-associated major events occurred in 3.4% (n= 10/292). Conclusions-Although mostly applied as a bail-out strategy for complex lesions, the frequency, outcomes, and low complication rate of the ADR technique and its subtypes confirm the benefit and value of the technique in hybrid chronic total occlusion percutaneous coronary intervention, especially when antegrade wiring or retrograde approaches are not feasible.
Notes: [Maeremans, Joren; Dens, Jo] Univ Hasselt, Fac Med & Life Sci, Hasselt, Belgium. [Maeremans, Joren; Dens, Jo] Ziekenhuis Oost Limburg, Dept Cardiol, Schiepse Bos 6, B-3600 Genk, Belgium. [Spratt, James C.; Wilson, William] Forth Valley Royal Hosp, Dept Cardiol, Edinburgh, Midlothian, Scotland. [Bagnall, Alan J.; Egred, Mohaned] Freeman Rd Hosp, Dept Cardiol, Newcastle Upon Tyne, Tyne & Wear, England. [Bagnall, Alan J.; Egred, Mohaned] Newcastle Univ, Inst Cellular Med, Newcastle Upon Tyne, Tyne & Wear, England. [Stuijfzand, Wynand; Nap, Alexander; Knaapen, Paul] Vrije Univ Amsterdam, Med Ctr, Dept Cardiol, Amsterdam, Netherlands. [Agostoni, Pierfrancesco] Univ Med Ctr Utrecht, Dept Cardiol, Utrecht, Netherlands. [Agostoni, Pierfrancesco] St Antonius Hosp, Dept Cardiol, Nieuwegein, Netherlands. [Hanratty, Colm G.] Belfast City Hosp, Dept Cardiol, Belfast, Antrim, North Ireland. [Faurie, Benjamin] Grp Hosp Mutualiste, Dept Cardiol, Grenoble, France. [Avran, Alexandre] Clin Marignane, Dept Cardiol, Marignane, France. [Bressollette, Erwan] Nouvelles Clin Nantaises, Dept Cardiol, Nantes, France.
URI: http://hdl.handle.net/1942/24340
DOI: 10.1161/CIRCINTERVENTIONS.116.004791
ISI #: 000403445700007
ISSN: 1941-7640
Category: A1
Type: Journal Contribution
Appears in Collections: Research publications

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