100.80 Investment Procedures in CTO-PCI: Real World Experience

Document Type

Conference Proceeding

Publication Date

2-24-2025

Publication Title

JACC Cardiovasc Interv

Keywords

adult, aged, clinical outcome, cohort analysis, complication, conference abstract, electronic medical record, female, follow up, human, investment, major clinical study, male, prospective study, retrospective study, special situation for pharmacovigilance

Abstract

Background: With increased CTO complexity comes lower success rates and higher complications. Investment has been introduced as a technique to overcome the most challenging of CTOs in a planned or ad-hoc fashion, which is believed to improve procedure success. However, no randomized trials have yet to support that evidence and real-world experience has been limited. Methods: We conducted a retrospective cohort analysis of patients who underwent CTO PCI between 2015 and 2023 at Henry Ford Hospital, Detroit, MI. Patients were selected from the HFH pool of the PROGRESS CTO registry and followed via EMR review, we collected Baseline characteristics, procedural details, and clinical outcomes. Results: 67 subjects were included in the final analysis, Target CTO lesions included RCA (55.2%), LAD (26.9%), and LCX (26.9%). Median (IQR) J-CTO score was 3 (2-4), and time to completion procedure was 60 days. TIMI flow > 0 was achieved in 82% of patients after the initial procedure, of whom 19 (35%) maintained TIMI flow on follow-up. Successful crossing strategy was AWE (41%), ADR (30%), and retrograde approach (29%). Final technical success was 83.6%. Composite complications was 13% for both procedures, with very low 30-day MACE rate of 1.5%. Conclusion: This retrospective cohort study reflects real world experience at a high-volume center and showed the effectiveness of investment technique in improving the success rate of a complex subcategory of an already challenging procedure. Prospective studies are warranted to validate these findings and refine strategies for optimizing outcomes. [Formula presented]

Volume

18

Issue

4

First Page

S12

Last Page

S13

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