Participating Centers
Data collection was carried out at 44 centers across Europe: in Latvia (2 centers in Riga), Denmark
(Aarhus), Sweden (Lund), Scotland (Larbert), England (Leicester, Bristol, London, and Brighton),
Germany (Hamburg, Erfurt, Dusseldorf, Bad Berka, Bad Soden, Frankfurt, Darmstadt, Ulm,
Konstanz, and Bad Krozingen), Poland (Lublin and 2 centers in Krakow), France (Lagny-surMarne, Massy, Saint-Etienne, Rangueil, Toulouse, and Marseille), Switzerland (St. Gallen), Spain
(2 centers in Madrid and 2 centers in Barcelona), Italy (3 centers in Turin, Milan, and Catania),
Bulgaria (Sofia), Turkey (Istanbul and Eskisehir), and Greece (Thessaloniki), by a total of 45
interventionalists.
The authors thank all the coordinators and investigators who contributed to the recruitment in the
different centers: Dr. Joachim Schofer (Andreas Gruntzig-Haus, Hamburg, Germany), Dr. Julian
Strange (Bristol Heart Institute, Bristol, United Kingdom), Dr. Dariusz Dudek (Jagiellonian
University, Krakow, Poland), Dr. Horst Sievert (Cardiovasculares Centrum, Frankfurt, Germany),
Dr. Didier Tchetche (Clinique Pasteur, Toulouse, France), Dr. Alexandre Avran (Clinique de
Marignane, Marseille, France), Dr. Ralph Schulze (Herzklinik, Ulm, Germany), Dr. Michael Pieper
(Herzzentrum Bodensee, Kreuzlingen, Germany), Dr. Victoria Martin (Hospital de la Santa Cruz y
San Pablo, Barcelona, Spain), Dr. Karl Isaaz (University of Saint Etienne, Saint Etienne, France),
Dr. Daniel Weilenmann (Kantonsspital, St. Gallen, Switzerland), Dr. Goran Olivercrona (University
Hospital, Lund, Sweden), Dr. Jan Harnek (Lunds Universitetssjukhus, Sweden), Dr. Javier Goicolea
(Invasive Cardiology Hospital, Madrid, Spain), Dr. Jaroslaw Wojcik (Medical University of Lublin,
Lublin, Poland), Dr. Nicolas Boudou (Rangueil University Hospital, Toulouse, France), Dr. Tevfik
Gurmen (University of Istanbul Haseki, Istanbul, Turkey), Dr. Anthony Gershlick (University
Hospitals of Leicester, Leicester, United Kingdom), Dr. Hans Bonnier (Universitair Ziekenhuis,
Brussels, Belgium), Dr. Jacques Koolen (Catharina Hospital, Endhoven, the Netherlands), Dr.
Imhad Sheiban (San Giovanni Battista Hospital, Turin, Italy), Dr. Guy Heindrickx (Cardiovascular
Center, Aalst, Belgium), Dr. Gennaro Sardella (Policlinico Umberto I, Sapienza University, Rome,
Italy), Dr. Dobri Hazarbasanov (St. Anna University Hospital, Sofia, Bulgaria), Dr. Emanuele
Berbato (OLV Hospital, Aalst, Belgium), Dr. Bernhard Reimers (Mirano Hospital, Milan, Italy),
Dr. Karl-Eugen Hauptmann (Bruderkrankenhaus Trier, Germany), Bernard Chevalier (Hospital
Jacques Cartier, Massy, France), Dr. Kambis Mashayekhi (Helios Klinikum, Plauen, Germany), Dr.
Luca Grancini (Cardiologico Monzino, Milan, Italy), Dr. Jean Fajadet (Clinique Pasteur, Toulouse,
France), Dr. Mauro de Benedictis (Mauriziano Hospital, Turin, Italy), and Dr. Antonio Colombo
(San Raffaele Hospital, Milan, Italy).
Supplemental Table 1: Procedural complications and in-hospital outcomes in retrograde and
antegrade lesions during the study period (2008-2012).
RETROGRADE
ANTEGRADE
P value
(N=1582)
(N=8007)
Procedural complications
108 (6.8)
310 (3.9)
<0.0001
PE - without tamponade
9 (0.6)
6 (0.1)
<0.0001
PE- with tamponade
15 (1.0)
21 (0.3)
<0.0001
PE - Surgical intervention
2 (0.1)
2 (0.02)
0.07
Collateral perforation / hematoma
31 (2.0)
107 (1.3)
0.06
Stent thrombosis
3 (0.2)
6 (0.1)
0.17
Vascular complications
16 (1.0)
58 (0.7)
0.23
Collateral donor vessel thrombus
30 (1.9)
75 (0.9)
0.0008
Non Q-wave MI
5 (0.3)
11 (0.1)
0.11
Q-wave MI
2 (0.1)
8 (0.1)
0.77
Emergency CABG
2 (0.1)
3 (0.04)
0.19
Emergency re-PCI
2 (0.1)
7 (0.09)
0.65
or dissection
In-hospital outcomes
Death
2 (0.1)
15 (0.2)
0.35
Stroke
0
1 (0.01)
NC
CABG= coronary artery bypass grafting; MI= myocardial infarction; PE = pericardial effusion;
NC= statistical data not converge; PCI=percutaneous coronary intervention.
Supplemental Table 2: Clinical and angiographic characteristics (percentages) of patients
compliant vs those lost to follow up.
Variables
Overall
(n=1395)
Patients with
Patients lost to
follow-up
follow-up
p-value
(n=931, 66.7%) (n=464, 23.3%)
62.0±10.4
62.2± 9.3
61.6±10.9
0.19
Men
88.5
88.2
89.2
0.37
Current / former smoker
57.9
62.1
49.5
<0.001
Hypertension
77.3
77.7
76.5
0.62
Hyperlipidemia
78.9
84.9
67.0
<0.001
Diabetes
29.0
28.9
29.3
0.92
Left ventricular EF <35%
6.0
5.9
6.3
0.89
History of MI
43.5
43.3
43.9
0.69
History of CABG
17.6
17.0
18.7
0.32
History of stroke
2.5
2.3
2.6
0.96
Prior PCI
55.9
62.9
41.8
<0.001
Multi-vessel coronary disease
59.8
59.6
60.1
0.62
Age, yrs (mean ± SD)
0.27
CTO target vessel
RCA
70.4
70.4
70.5
LCX
7.8
3.9
15.5
LAD
20.3
23.8
13.3
LM/graft
1.5
1.9
0.7
42.5
41.5
44.6
0.17
3 (2-3)
3 (2-3)
3 (2-3)
0.12
76.0
75.1
77.8
0.21
Prior failed antegrade attempt
for CTO PCI
J-CTO score for retrograde
(median, IIQ)
Successful retrograde PCI
CABG=coronary artery bypass grafting; EF=ejection fraction; LAD=left anterior descending;
LCX=left circumflex; LM=left main; MI=myocardial infarction; PCI=percutaneous coronary
intervention; RCA=right coronary artery.
Supplemental Figure: Follow-up of Patients Undergoing Retrograde PCIRetrograde PCI was
attempted in 1,395 patients; follow-up data were available in 931 patients.
PCI = percutaneous coronary intervention.