Please use this identifier to cite or link to this item:
Title: Antegrade Dissection and Reentry as Part of the Hybrid Chronic Total Occlusion Revascularization Strategy A Subanalysis of the RECHARGE Registry (Registry of CrossBoss and Hybrid Procedures in France, the Netherlands, Belgium and United Kingdom)
Authors: MAEREMANS, Joren 
Spratt, James C.
Bagnall, Alan J.
Stuijfzand, Wynand
Nap, Alexander
Agostoni, Pierfrancesco
Wilson, William
Hanratty, Colm G.
Wilson, Simon
Faurie, Benjamin
Avran, Alexandre
Bressollette, Erwan
Egred, Mohaned
Knaapen, Paul
Walsh, Simon
Issue Date: 2017
Abstract: Background-Development of the CrossBoss and Stingray devices for antegrade dissection and reentry (ADR) of chronic total occlusions has improved historically suboptimal outcomes. However, the outcomes, safety, and failure modes of the technique have to be studied in a larger patient cohort. This preplanned substudy of the RECHARGE registry (Registry of CrossBoss and Hybrid Procedures in France, the Netherlands, Belgium and United Kingdom) aims to evaluate the value and use of ADR and determine its future position in contemporary chronic total occlusion intervention. Methods and Results-Patients were selected if an ADR strategy was applied. Outcomes, safety, and failure modes of the technique were assessed. The ADR technique was used in 23% (n= 292/1253) of the RECHARGE registry and was mainly applied for complex lesions (Japanese chronic total occlusion score= 2.7 +/- 1.1). ADR was the primary strategy in 30% (n= 88/292), of which 67% were successful. Bail-out ADR strategies were successful in 63% (n= 133/210). The Controlled ADR (ie, combined CrossBoss-Stingray) subtype was applied most frequently (32%; n= 93/292) and successfully (81%; n= 75/93). Overall perlesion success rate was 78% (n= 229/292), after use of additional bail-out strategies. The inability to reach the distal target zone (n= 48/100) or to reenter (n= 43/100) most commonly led to failure. ADR-associated major events occurred in 3.4% (n= 10/292). Conclusions-Although mostly applied as a bail-out strategy for complex lesions, the frequency, outcomes, and low complication rate of the ADR technique and its subtypes confirm the benefit and value of the technique in hybrid chronic total occlusion percutaneous coronary intervention, especially when antegrade wiring or retrograde approaches are not feasible.
Notes: [Maeremans, Joren; Dens, Jo] Univ Hasselt, Fac Med & Life Sci, Hasselt, Belgium. [Maeremans, Joren; Dens, Jo] Ziekenhuis Oost Limburg, Dept Cardiol, Schiepse Bos 6, B-3600 Genk, Belgium. [Spratt, James C.; Wilson, William] Forth Valley Royal Hosp, Dept Cardiol, Edinburgh, Midlothian, Scotland. [Bagnall, Alan J.; Egred, Mohaned] Freeman Rd Hosp, Dept Cardiol, Newcastle Upon Tyne, Tyne & Wear, England. [Bagnall, Alan J.; Egred, Mohaned] Newcastle Univ, Inst Cellular Med, Newcastle Upon Tyne, Tyne & Wear, England. [Stuijfzand, Wynand; Nap, Alexander; Knaapen, Paul] Vrije Univ Amsterdam, Med Ctr, Dept Cardiol, Amsterdam, Netherlands. [Agostoni, Pierfrancesco] Univ Med Ctr Utrecht, Dept Cardiol, Utrecht, Netherlands. [Agostoni, Pierfrancesco] St Antonius Hosp, Dept Cardiol, Nieuwegein, Netherlands. [Hanratty, Colm G.] Belfast City Hosp, Dept Cardiol, Belfast, Antrim, North Ireland. [Faurie, Benjamin] Grp Hosp Mutualiste, Dept Cardiol, Grenoble, France. [Avran, Alexandre] Clin Marignane, Dept Cardiol, Marignane, France. [Bressollette, Erwan] Nouvelles Clin Nantaises, Dept Cardiol, Nantes, France.
Keywords: antegrade dissection and reentry; (coronary) chronic total occlusion; hybrid; percutaneous coronary intervention; registry;antegrade dissection and reentry; (coronary) chronic total occlusion; hybrid; percutaneous coronary intervention; registry
Document URI:
ISSN: 1941-7640
e-ISSN: 1941-7632
DOI: 10.1161/CIRCINTERVENTIONS.116.004791
ISI #: 000403445700007
Rights: © 2017 American Heart Association, Inc
Category: A1
Type: Journal Contribution
Validations: ecoom 2018
Appears in Collections:Research publications

Files in This Item:
File Description SizeFormat 
  Restricted Access
Published version594.61 kBAdobe PDFView/Open    Request a copy
Supplemental_Material_DENS_CIRC_Intv.pdfSupplementary Material405.05 kBAdobe PDFView/Open
Supplemental_Review_Material_DENS_CIRC_Intv.pdfSupplementary Material432.95 kBAdobe PDFView/Open
Figure_1_DENS_CIRC_Intv (1).tifSupplementary Material7.84 MBTIFFView/Open
Figure_2_DENS_CIRC_Intv (1).tifSupplementary Material5.64 MBTIFFView/Open
Manuscript_DENS_CIRC_Intv_Final.pdfPeer-reviewed author version847.72 kBAdobe PDFView/Open
Show full item record


checked on Sep 7, 2020


checked on May 29, 2022

Page view(s)

checked on May 28, 2022


checked on May 28, 2022

Google ScholarTM



Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.