Antegrade dissection and re-entry vs retrograde strategy in chronic total occlusion percutaneous coronary intervention: Rationale and design of the ADRENALINE randomized study.
Am Heart JJul 11, 2026 (epub)
Clinical ResearchCardiology
Maksymilian P Opolski, Mateusz Spiewak, Filip Machaj et al.
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In 30 seconds
The ADRENALINE study is a multicenter randomized controlled trial comparing antegrade dissection and re-entry (ADR) to retrograde strategies in chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Enrolling 121 patients with difficult CTO lesions, the study aims to assess total procedure time and successful guidewire crossing as co-primary endpoints. The trial is currently ongoing with 45 patients enrolled.
Key findings
- The study plans to enroll 121 patients with J-CTO score ≥2 for CTO-PCI.
- Co-primary endpoints include total procedure time and successful guidewire crossing.
- The first patient was enrolled on July 29, 2025, with 45 patients enrolled as of June 14, 2026.
Why it matters
Understanding the comparative effectiveness of ADR versus retrograde strategies in CTO PCI could enhance procedural success rates and improve patient outcomes, particularly in complex cases where standard approaches may fail.