Lirui Yang, Tao Zhang, Gang Wang, Leisheng Ru, Lin Zhao
{"title":"CTO-PCI 中初级 ADR 与救助 ADR 的比较分析","authors":"Lirui Yang, Tao Zhang, Gang Wang, Leisheng Ru, Lin Zhao","doi":"10.1155/2024/4501880","DOIUrl":null,"url":null,"abstract":"<div>\n <p><b>Objective:</b> To compare the efficiency and safety of primary and bailout antegrade dissection and re-entry (ADR) during percutaneous coronary intervention (PCI) for chronic total occluded (CTO) lesions.</p>\n <p><b>Methods:</b> Patients who underwent ADR procedures for CTO lesions were enrolled in this study and were divided into two groups (primary ADR and bailout ADR) based on the initiation of ADR during PCI. The success rate and major adverse cardiovascular and cerebrovascular events (MACCE) during hospitalization were assessed as the primary endpoints. Procedure time, fluoroscopy time, wire crossing time, radiation dose, and contrast volume were considered as secondary endpoints.</p>\n <p><b>Results:</b> A total of 243 patients were enrolled in this study, with 127 patients receiving primary ADR and 116 receiving bailout ADR. No differences were found in baseline parameters between the two groups. The success rate was significantly higher in the primary ADR group compared to the bailout ADR group (89.0% versus 77.6%, respectively; <i>p</i> = 0.017). The incidence of in-hospital MACCE was low in both groups, with no significant differences observed between them. Procedure time, radiation dose, and contrast volume were lower in the primary ADR group compared to the bailout ADR group. Cox regression analysis revealed that primary ADR and J-CTO score ≥ 3 were independent predictors of technical success in CTO-PCI.</p>\n <p><b>Conclusions:</b> Both primary and bailout ADR are safe strategies for CTO-PCI. Primary ADR significantly improves the success rate of PCI for CTO compared to bailout ADR, with shorter operation time, lower radiation dose, and reduced contrast volume.</p>\n </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/4501880","citationCount":"0","resultStr":"{\"title\":\"A Comparative Analysis of Primary and Bailout ADR in CTO-PCI\",\"authors\":\"Lirui Yang, Tao Zhang, Gang Wang, Leisheng Ru, Lin Zhao\",\"doi\":\"10.1155/2024/4501880\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n <p><b>Objective:</b> To compare the efficiency and safety of primary and bailout antegrade dissection and re-entry (ADR) during percutaneous coronary intervention (PCI) for chronic total occluded (CTO) lesions.</p>\\n <p><b>Methods:</b> Patients who underwent ADR procedures for CTO lesions were enrolled in this study and were divided into two groups (primary ADR and bailout ADR) based on the initiation of ADR during PCI. The success rate and major adverse cardiovascular and cerebrovascular events (MACCE) during hospitalization were assessed as the primary endpoints. Procedure time, fluoroscopy time, wire crossing time, radiation dose, and contrast volume were considered as secondary endpoints.</p>\\n <p><b>Results:</b> A total of 243 patients were enrolled in this study, with 127 patients receiving primary ADR and 116 receiving bailout ADR. No differences were found in baseline parameters between the two groups. The success rate was significantly higher in the primary ADR group compared to the bailout ADR group (89.0% versus 77.6%, respectively; <i>p</i> = 0.017). The incidence of in-hospital MACCE was low in both groups, with no significant differences observed between them. Procedure time, radiation dose, and contrast volume were lower in the primary ADR group compared to the bailout ADR group. Cox regression analysis revealed that primary ADR and J-CTO score ≥ 3 were independent predictors of technical success in CTO-PCI.</p>\\n <p><b>Conclusions:</b> Both primary and bailout ADR are safe strategies for CTO-PCI. Primary ADR significantly improves the success rate of PCI for CTO compared to bailout ADR, with shorter operation time, lower radiation dose, and reduced contrast volume.</p>\\n </div>\",\"PeriodicalId\":16329,\"journal\":{\"name\":\"Journal of interventional cardiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-11-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/4501880\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of interventional cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1155/2024/4501880\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of interventional cardiology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1155/2024/4501880","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
A Comparative Analysis of Primary and Bailout ADR in CTO-PCI
Objective: To compare the efficiency and safety of primary and bailout antegrade dissection and re-entry (ADR) during percutaneous coronary intervention (PCI) for chronic total occluded (CTO) lesions.
Methods: Patients who underwent ADR procedures for CTO lesions were enrolled in this study and were divided into two groups (primary ADR and bailout ADR) based on the initiation of ADR during PCI. The success rate and major adverse cardiovascular and cerebrovascular events (MACCE) during hospitalization were assessed as the primary endpoints. Procedure time, fluoroscopy time, wire crossing time, radiation dose, and contrast volume were considered as secondary endpoints.
Results: A total of 243 patients were enrolled in this study, with 127 patients receiving primary ADR and 116 receiving bailout ADR. No differences were found in baseline parameters between the two groups. The success rate was significantly higher in the primary ADR group compared to the bailout ADR group (89.0% versus 77.6%, respectively; p = 0.017). The incidence of in-hospital MACCE was low in both groups, with no significant differences observed between them. Procedure time, radiation dose, and contrast volume were lower in the primary ADR group compared to the bailout ADR group. Cox regression analysis revealed that primary ADR and J-CTO score ≥ 3 were independent predictors of technical success in CTO-PCI.
Conclusions: Both primary and bailout ADR are safe strategies for CTO-PCI. Primary ADR significantly improves the success rate of PCI for CTO compared to bailout ADR, with shorter operation time, lower radiation dose, and reduced contrast volume.
期刊介绍：
Journal of Interventional Cardiology is a peer-reviewed, Open Access journal that provides a forum for cardiologists determined to stay current in the diagnosis, investigation, and management of patients with cardiovascular disease and its associated complications. The journal publishes original research articles, review articles, and clinical studies focusing on new procedures and techniques in all major subject areas in the field, including:
Acute coronary syndrome
Coronary disease
Congenital heart diseases
Myocardial infarction
Peripheral arterial disease
Valvular heart disease
Cardiac hemodynamics and physiology
Haemostasis and thrombosis
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