Comparing two methods for opening fully blocked heart arteries
Compares two procedures for opening completely blocked coronary arteries in adults with heart disease.
Plain-language title generated from the registry record
Registry title: Antegrade Dissection and Re-entry Versus Retrograde Strategy in CTO PCI
Key facts
- Where
- Lublin and Warsaw, PolandSee the 3 sites
Where in Poland
- 1st Military Clinical HospitalLublin, PolandTaking people
- Hospital of the Ministry of the Interior and AdministrationLublin, PolandTaking people
- National Institute of CardiologyWarsaw, PolandTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- National Institute of Cardiology, Warsaw, Poland
- Trial code
- NCT06878729
- Record updated
- 2 January 2026
- Original description
The ADRENALINE trial has been designed as a multi-center, prospective randomized study to compare the procedural and periprocedural outcomes of coronary chronic total occlusion (CTO) percutaneous coronary intervention (PCI) using antegrade dissection and re-entry (ADR) versus retrograde strategy. Beyond the patient-oriented outcomes, the influence of the studied CTO PCI strategies on the stress levels among interventional cardiologists will be explored.Read full original descriptionShow less
Antegrade Dissection and Re-entry Versus Retrograde Strategy in Chronic Total Occlusion Percutaneous Coronary Intervention
The ADRENALINE trial has been designed as a multi-center, prospective randomized study to compare the procedural and periprocedural outcomes of coronary chronic total occlusion (CTO) percutaneous coronary intervention (PCI) using antegrade dissection and re-entry (ADR) versus retrograde strategy. Beyond the patient-oriented outcomes, the influence of the studied CTO PCI strategies on the stress levels among interventional cardiologists will be explored.
The main questions it aims to answer are as follows:
* What is the difference between ADR versus retrograde strategy with regard to total procedure time, the rates of successful guidewire crossing and periprocedural complications as well as stress levels experienced by interventional cardiologists? * Is retrograde approach associated with higher rates of myocardial injury/infarction based on cardiac troponin/cardiac magnetic resonance (CMR) as compared with ADR?
Participants will undergo pre- and postprocedural laboratory testing (cardiac troponin, CK-MB), CMR for late gadolinium enhancement and health status assessment. Subjects undergoing successful CTO PCI using antegrade wiring strategy will be included in the observational arm.
Inclusion: 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: acute myocardial infarction; severe valvular disease; contrast allergy; <18 years of age; cardiogenic shock; estimated life expectancy <1 year; contraindication to PCI; 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.