International survey of chronic total occlusion percutaneous coronary intervention operators
Recommended Citation
Simsek B, Rempakos A, Kostantinis S, Alexandrou M, Karacsonyi J, Rangan BV, Mastrodemos OC, Mutlu D, Abi Rafeh N, Alaswad K, Avran A, Azzalini L, ElGuindy A, Egred M, Goktekin O, Gorgulu S, Jaber W, Kearney KE, Kirtane AJ, Lombardi WL, Mashayekhi K, McEntegart M, Nicholson W, Rinfret S, Allana SS, Sandoval Y, Nicholas Burke M, and Brilakis ES. International survey of chronic total occlusion percutaneous coronary intervention operators. Catheter Cardiovasc Interv 2023.
Document Type
Article
Publication Date
1-1-2024
Publication Title
Catheterization and cardiovascular interventions
Abstract
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.
Medical Subject Headings
Male; Humans; United States; Female; Treatment Outcome; Percutaneous Coronary Intervention; Coronary Occlusion; Chronic Disease; Time Factors; Registries; Heart Injuries; Coronary Angiography; Risk Factors
PubMed ID
37983649
ePublication
ePub ahead of print
Volume
103
Issue
1
First Page
12
Last Page
19
