July 11, 2026 · American heart journal · DOI: 10.1016/j.ahj.2026.107538

Antegrade dissection and re-entry versus retrograde strategy in chronic total occlusion percutaneous coronary intervention: Rationale and design of the ADRENALINE randomized study

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The ADRENALINE study aims to compare the effectiveness of antegrade dissection and re-entry (ADR) versus retrograde strategies in chronic total occlusion (CTO) percutaneous coronary intervention (PCI) for patients with difficult lesions. By enrolling 121 patients, the study will assess procedural outcomes, including total procedure time and successful guidewire crossing, as well as the impact on myocardial infarction and quality of life. This research seeks to provide clearer insights into the optimal approach for challenging CTO cases.

Maksymilian P Opolski, Mateusz Spiewak, Filip Machaj, Hubert Borzuta, Grzegorz Sobieszek, Jakub Drozd, Filip Kiljanski, Pavlo Matsko, Mariusz Klopotowski, Bartosz Zieba, Wojciech Kula, Magdalena Marczak, Artur Debski, Adam Witkowski, Paul Knaapen, Gregor Leibundgut, Claudiu Ungureanu, Stéphane Rinfret, Emmanouil S Brilakis

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Antegrade dissection and re-entry versus retrograde strategy in chronic total occlusion percutaneous coronary intervention: Rationale and design of the ADRENALINE randomized study

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