Clinical analysis of antegrade dissection re-entry technique for coronary chronic occlusion lesion

Abstract:

Objective To investigate the efficacy and safety of antegrade dissection re-entry（ADR） technique in percutaneous coronary intervention （PCI） in coronary chronic total occlusion（CTO） lesions.Methods A total of 98 patients with CTO who received PCI treatment in Binzhou People's Hospital and The Second Affiliated Hospital of Nanchang University from January 2017 and December 2018 were included in the study. Among them，48 patients were given traditional PCI treatment without ADR technique（control group） and 50 patients were treated with ADR technique（treatment group）. The baseline conditions， coronary angiography results，PCI success rate，and major adverse cardiovascular events（MACE） for 12 months of follow-up were compared between the two groups.Results There were 52 CTO lesions in 48 patients in the control group and 58 ones in 50 patients in the treatment group. The success rate of PCI in the treatment group was significantly higher than that in the control group（89.7% vs. 71.2%，P=0.047），in which，6 cases of CTO due to in-stent restenosis（ISR-CTO） in treatment group were all open. The mean PCI time [（71±25） min vs. （95±33） min，P=0.041]，X-ray exposure time [（42±17） min vs. （71±22） min，P=0.032] and contrast dose [（98±26） mL vs. （178±63） mL，P=0.029] in the treatment group were significantly lower than those in the control group，and all the differences were statistically significant. The incidence of MACE（22.0% vs. 41.7%， P=0.046） and recurrent myocardial infarction（10.0% vs. 27.1%，P=0.047） after 12 months of follow-up were significantly lower in the treatment group than in the control group，and the differences were statistically significant.Conclusion The application of ADR in coronary CTO lesion PCI is safe and effective，which shortens the operation time，reduces the radiation dose and contrast dose of doctors and patients，and improves the prognosis of patients.