Antegrade Dissection and Re-entry Versus Retrograde Strategy in CTO PCI

Launched by NATIONAL INSTITUTE OF CARDIOLOGY, WARSAW, POLAND · Mar 10, 2025

Keywords

ClinConnect Summary

The ADRENALINE trial is planned as a multicenter, prospective randomized research experiment in patients with clinical indication for PCI of CTO. The target population will comprise patients with at least difficult CTO (J-CTO score ≥2) and angiographic equipoise for either ADR or the retrograde CTO recanalization strategy as evaluated by 2 independent CTO PCI operators. The pre-procedural assessment will comprise cardiac magnetic resonance (CMR) for late gadolinium enhancement, laboratory testing (cardiac troponin, creatine kinase-MB) and health status assessed by the Seattle angina questio...

Gender

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Eligibility criteria

• Inclusion Criteria:
• • clinical indication for CTO PCI as determined by the local heart team (presence of angina or equivalent symptoms and/or documented ischemia or viability)
• • at least difficult native CTO lesion with J-CTO difficulty score ≥2 points on invasive angiography
• • angiographic suitability for both ADR and the retrograde strategy as assessed by 2 independent hybrid CTO PCI operators
• • informed consent for participation in the study
• Exclusion Criteria:
• • \<18 years of age
• • acute myocardial infarction
• • cardiogenic shock
• • severe valvular disease
• • estimated life expectancy \<1 year
• • contraindication to PCI
• • contrast allergy
• • positive pregnancy test or breast-feeding
• • native CTO lesion with easy or intermediate difficulty score on invasive angiography (J-CTO score \<2 points)
• • lack of angiographic equipoise between the ADR and the retrograde strategy as assessed by 2 independent hybrid CTO PCI operators

Trial Officials