Coronary disease & ACS

Antegrade dissection and re-entry vs retrograde strategy in chronic total occlusion percutaneous coronary intervention: Rationale and design of the ADRENALINE randomized study

Am Heart JPublished prospective, multicenter randomized study with a superiority design

Study context

Population
Patients with difficult coronary chronic total occlusion (CTO) (J-CTO score ≥2) referred for CTO-PCI in accordance with the hybrid algorithmplanned enrolment, n = 74 randomized
Participants
121 patients
Planned comparison
ADR vs retrograde strategy for difficult CTO percutaneous coronary intervention (PCI)
Primary endpoint
Total procedure time and successful guidewire crossing (co-primary)
Methodological detailsobservational arm for successful antegrade wiring (AW), 1:1 randomization
  • Observational arm for successful AW
  • 1:1 randomization

No results yet. This paper sets out the design of a trial; its results are to come.

Further findings

Enrolment status · As of June 14, 2026

Patients enrolled of the planned 121
45
Randomized
26
Observational
19
  • The first patient was enrolled on July 29, 2025.

Original publication

Antegrade dissection and re-entry vs retrograde strategy in chronic total occlusion percutaneous coronary intervention: Rationale and design of the ADRENALINE randomized study. Am Heart J. Published 11 July 2026. doi:10.1016/j.ahj.2026.107538

Summarised from the published abstract; every number is checked against it

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