Reclassification of Chronic Total Occlusion (CTO) Crossing Strategies in the ERCTO Registry According to the CTO-ARC Consensus Recommendations
Authors' conclusion
The application of CTO-ARC definitions allowed the reclassification of 6.7% of procedures as alternative antegrade crossing with retrograde or antegrade contribution which showed higher MACCE and lower technical success rates, as compared with true antegrade and retrograde crossing.
Study context
- Population
- Patients undergoing CTO PCI in the European Registry of Chronic Total Occlusions, 2021–2022
- Participants
- 8,673 patients
- Exposure
- Alternative antegrade vs retrograde vs true antegrade CTO crossing
- Outcome
- Numbers, efficacy and safety of each final CTO crossing strategy per CTO-ARC recommendations
Methodological detailsregistry
- Registry
Main finding
As reported in the abstract
Technical success
P < 0.001
Observational data: associations, not effects.
Further findings
Distribution of crossing strategies
- Antegrade approach
- 79.2%
- Retrograde approach
- 20.8%
- Antegrade wiring without retrograde contribution
- n = 5,929 [68.4%]
- Antegrade wiring with retrograde contribution
- n = 446 [5.1%]
- Antegrade dissection and re-entry without retrograde contribution
- n = 353 [4.1%]
- Antegrade dissection and re-entry with retrograde contribution
- n = 137 [1.6%]
- Retrograde wiring
- n = 735 [8.4%]
- Retrograde dissection and re-entry
- n = 1,073 [12.4%]
Safety
Complications · across the three strategies
P < 0.001
Original publication
Reclassification of CTO Crossing Strategies in the ERCTO Registry According to the CTO-ARC Consensus Recommendations. JACC Cardiovasc Interv. Published 28 October 2024. doi:10.
Summarised from the published abstract; every number is checked against it