Further validation of the hybrid algorithm for CTO PCI; difficult lesions, same success

Mir B. Basir, Aris Karatasakis, Mohammad Alqarqaz, Barbara Danek, Bavana V. Rangan, Emmanouil S. Brilakis, Henry Kim, William W. O'Neill, Khaldoon Alaswad

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Objectives: To evaluate the success rates and outcome of the hybrid algorithm for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) by a single operator in two different clinical settings. Methods: We compared 279 consecutive CTO PCIs performed by a single, high-volume operator using the hybrid algorithm in two different clinical settings. Data were collected through the PROGRESS CTO Registry. We compared 145 interventions performed in a community program (cohort A) with 134 interventions performed in a referral center (cohort B). Results: Patient in cohort B had more complex lesions with higher J-CTO (3.0 vs. 3.41; p. <. 0.001) and Progress CTO (1.5 vs.1.8, P = 0.003) scores, more moderate to severe tortuosity (38% vs. 64%; p. <. 0.001), longer total occlusion length (25 vs. 40. mm; p. <. 0.001) and higher prevalence of prior failed CTO PCI attempts (15% vs. 35%; p = 0.001). Both technical (95% vs. 91%; p = 0.266) and procedural (94% vs. 88%; p = 0.088) success rates were similar between the two cohorts despite significantly different lesion complexity. Overall major adverse cardiovascular events were higher in cohort B (1.4% vs. 7.8%; p = 0.012) without any significant difference in mortality (0.7% vs. 2.3%, p = 0.351). Conclusions: In spite of higher lesion complexity in the setting of a quaternary-care referral center, use of the hybrid algorithm for CTO PCI enabled similarly high technical and procedural success rates as compared with those previously achieved by the same operator in a community-based program at the expense of a higher rate of MACE.

Original languageEnglish (US)
JournalCardiovascular Revascularization Medicine
StateAccepted/In press - Nov 29 2016


  • Chronic Total occlusion
  • PCI

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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