Optimal time for collateral channel wiring in retrograde chronic total occlusion percutaneous coronary intervention

Collateral channel wiring (CCW) is important in a retrograde chronic total occlusion (CTO) procedure. However, the guidance is insufficient. To investigate the optimal CCW time, patients who had received retrograde CTO procedures were enrolled. The optimal CCW time was derived by Receiver Operating Characteristic curves regarding success rates or complications. The clinical outcomes in terms of success and complication rates were addressed by cutoff value of optimal CCW time. With cutoff values of 25 min, 191 (54.9%) had shorter CCW times and 157 (45.1%) had longer CCW times. The success rates were significantly higher in the group with shorter CCW times than in the group with longer CCW times (p < 0.05). Procedure-related myocardial infarction (MI) and collateral channel (CC) related complications were more frequently observed in longer CCW times group than shorter group. The CCW time less than 25 min was more likely to result in a technical success (adjusted odds ratio [aOR]: 3.69) and the odds of CC perforation decreased by approximately 80% (aOR: 0.20). A CCW time of less than 25 min may facilitate the success results and minimize the risk of complications in retrograde CTO procedures.