Strategy Selection and Outcomes of Tip-Detection in CTO-PCI: Intraplaque Tracking vs Antegrade Dissection and Re-Entry
Authors' conclusion
TD-primary ADR was preferentially selected for complex, calcified CTOs. Procedural efficiency appeared driven mainly by lesion characteristics rather than the initial TD strategy, supporting individualized TD strategy selection based on lesion morphology and technical feasibility.
Study context
- Population
- Tip-detection (TD)-attempted chronic total occlusion (CTO)-percutaneous coronary intervention cases from November 2020 to December 2023TD-attempted CTO-PCI cases, secondary metrics in 69 successful cases · TD-primary IPT 37 · TD-primary ADR 36
- Participants
- 73 cases
- Comparison
- TD-primary IPT vs TD-primary ADR
- TD-primary IPTn = 37
- TD-primary ADRn = 36
Main finding
As reported in the abstract
TD success
Further findings
Selection for J-CTO score ≥2
Selection for severe calcification
Lesion crossing time (successful cases) · shorter with TD-primary IPT
Stent length (successful cases) · shorter with TD-primary ADR
| Outcome | TD-primary IPT | TD-primary ADR |
|---|---|---|
| Final procedural success | 94.6% (95% CI 81.8%–99.3%) | 97.2% (95% CI 85.5%–99.9%) |
- Selection for J-CTO score ≥2: P = 0.043
- Selection for severe calcification: P < 0.001
- Lesion crossing time (successful cases): P = 0.046
- Stent length (successful cases): P = 0.041
Multivariable models
- Severe calcification was associated with longer lesion crossing time
- Bending ≥45° was associated with longer stent length
Original publication
Strategy Selection and Outcomes of Tip-Detection in CTO-PCI: Intraplaque Tracking vs Antegrade Dissection and Re-Entry. JACC Adv. Published 22 September 2026. doi:10.
Summarised from the published abstract; every number is checked against it