Coronary disease & ACSCohort study
Trends and Outcomes of Antegrade Dissection and Re-Entry in Chronic Total Occlusion Percutaneous Coronary Intervention
- Registry-based cohort study
- multicentre
- 46 US and non-US centres
Authors' conclusion
The use of ADR has been decreasing. ADR was used in more complex lesions and was associated with lower technical success and higher major adverse cardiac events compared with non-ADR cases. There has been a decrease in Stingray use and an increase in the use of STAR for re-entry.
Study context
- Population
- Patients undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in a multicentre registry, 2012–2023
- Participants
- 12,568 patients · 12,841 CTO PCIs
- Exposure
- ADR vs no ADR in CTO PCI
- ADRn = 2,385
- Outcome
- Frequency and outcomes of ADR use
Main finding
As reported in the abstract
ADR use
ADR
18.6%
2,385 of 2,385
- ADR use declined, 2012 vs 2022
- 37.9% to 14.5% (P < 0.001)
Observational data: associations, not effects.
Further findings
Technical success
P < 0.001
Mean
| Outcome | ADR | Non-ADR | P value |
|---|---|---|---|
| J-CTO score | 2.94 (SD 1.11) | 2.23 (SD 1.26) | P < 0.001 |
CrossBoss use and technical success
- CrossBoss use declined, 2012 to 2022
- 71% to 1.4%
- Technical success, CrossBoss vs wire-based techniques
- 87% vs 73%
Re-entry technique technical success and use
- Technical success, Stingray vs STAR vs limited antegrade subintimal tracking
- 86% vs 74% vs 78%
- Use in 2022, STAR vs Stingray
- 44% vs 38%
Safety
In-hospital MACE
P < 0.001
Original publication
Trends and Outcomes of Antegrade Dissection and Re-Entry in Chronic Total Occlusion Percutaneous Coronary Intervention. JACC Cardiovasc Interv. Published 23 October 2023. doi:10.1016/j.jcin.2023.09.021
Summarised from the published abstract; every number is checked against it