Catheterization and Cardiovascular Interventions | 2021
With great power comes great responsibility: When and how to use the retrograde approach to chronic total occlusion interventions
Abstract
• The retrograde approach to chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is a powerful tool for successful CTO crossing, especially in complex occlusions. • Compared with antegrade-only CTO PCI, the retrograde approach is associated with increased risk of periprocedural complications. • The retrograde approach should be used when the anticipated benefits outweigh the potential risks and should be performed in a meticulous, systematic, and stepwise fashion to maximize the likelihood of success and minimize the risk of complications.