TY - JOUR
T1 - International survey of chronic total occlusion percutaneous coronary intervention operators
AU - Simsek, Bahadir
AU - Rempakos, Athanasios
AU - Kostantinis, Spyridon
AU - Alexandrou, Michaella
AU - Karacsonyi, Judit
AU - Rangan, Bavana V.
AU - Mastrodemos, Olga C.
AU - Mutlu, Deniz
AU - Abi Rafeh, Nidal
AU - Alaswad, Khaldoon
AU - Avran, Alexandre
AU - Azzalini, Lorenzo
AU - ElGuindy, Ahmed
AU - Egred, Mohaned
AU - Goktekin, Omer
AU - Gorgulu, Sevket
AU - Jaber, Wissam
AU - Kearney, Kathleen E.
AU - Kirtane, Ajay J.
AU - Lombardi, William L.
AU - Mashayekhi, Kambis
AU - McEntegart, Margaret
AU - Nicholson, William
AU - Rinfret, Stephane
AU - Allana, Salman S.
AU - Sandoval, Yader
AU - Nicholas Burke, M.
AU - Brilakis, Emmanouil S.
N1 - Publisher Copyright:
© 2023 Wiley Periodicals LLC.
PY - 2024/1/1
Y1 - 2024/1/1
N2 - Background: Contemporary chronic total occlusion (CTO) percutaneous coronary intervention (PCI) practice has received limited study. Aim: To examine the contemporary CTO PCI practice. Methods: We performed an online, anonymous, international survey of CTO PCI operators. Results: Five hundred forty-five CTO PCI operators and 190 interventional cardiology fellows with an interest in CTO PCI participated in this survey. Almost half were from the United States (41%), most (93%) were men, and the median h/week spent in the hospital was 58. Median annual case numbers were 205 (150−328) for PCIs and 20 (5−50) for CTO PCIs. Almost one-fifth (17%) entered CTO cases into registries, such as PROGRESS-CTO (55%) and EuroCTO (20%). More than one-third worked at academic institutions (39%), 31% trained dedicated CTO fellows, and 22% proctored CTO PCI. One-third (34%) had dedicated CTO PCI days. Most (51%) never discharged CTO patients the same day, while 17% discharged CTO patients the same day >50% of the time. After successful guidewire crossing, 38% used intravascular imaging >90% of the time. Most used CTO scores including J-CTO (81%), PROGRESS-CTO (35%), and PROGRESS-CTO complications scores (30%). Coronary artery perforation was encountered within the last month by 19%. On a scale of 0−10, the median comfort levels in treating coronary artery perforation were: covered stents 8.8 (7.0−10), coil embolization 5.0 (2.1−8.5), and fat embolization 3.7 (0.6−7.3). Most (51%) participants had a complication cart/kit and 25% conducted regular complication drills with catheterization laboratory staff. Conclusion: Contemporary CTO PCI practices vary widely. Further research on barriers to following the guiding principles of CTO PCI may improve patient outcomes.
AB - Background: Contemporary chronic total occlusion (CTO) percutaneous coronary intervention (PCI) practice has received limited study. Aim: To examine the contemporary CTO PCI practice. Methods: We performed an online, anonymous, international survey of CTO PCI operators. Results: Five hundred forty-five CTO PCI operators and 190 interventional cardiology fellows with an interest in CTO PCI participated in this survey. Almost half were from the United States (41%), most (93%) were men, and the median h/week spent in the hospital was 58. Median annual case numbers were 205 (150−328) for PCIs and 20 (5−50) for CTO PCIs. Almost one-fifth (17%) entered CTO cases into registries, such as PROGRESS-CTO (55%) and EuroCTO (20%). More than one-third worked at academic institutions (39%), 31% trained dedicated CTO fellows, and 22% proctored CTO PCI. One-third (34%) had dedicated CTO PCI days. Most (51%) never discharged CTO patients the same day, while 17% discharged CTO patients the same day >50% of the time. After successful guidewire crossing, 38% used intravascular imaging >90% of the time. Most used CTO scores including J-CTO (81%), PROGRESS-CTO (35%), and PROGRESS-CTO complications scores (30%). Coronary artery perforation was encountered within the last month by 19%. On a scale of 0−10, the median comfort levels in treating coronary artery perforation were: covered stents 8.8 (7.0−10), coil embolization 5.0 (2.1−8.5), and fat embolization 3.7 (0.6−7.3). Most (51%) participants had a complication cart/kit and 25% conducted regular complication drills with catheterization laboratory staff. Conclusion: Contemporary CTO PCI practices vary widely. Further research on barriers to following the guiding principles of CTO PCI may improve patient outcomes.
KW - CTO PCI
KW - complex PCI
KW - complications
KW - contemporary practice
KW - well-being
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U2 - 10.1002/ccd.30914
DO - 10.1002/ccd.30914
M3 - Article
C2 - 37983649
AN - SCOPUS:85177233219
SN - 1522-1946
VL - 103
SP - 12
EP - 19
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 1
ER -