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1. Angiographic Features and Clinical Outcomes of Balloon Uncrossable Lesions during Chronic Total Occlusion Percutaneous Coronary Intervention

Author

Karacsonyi, Judit, Kostantinis, Spyridon, Simsek, Bahadir, Rempakos, Athanasios, Allana, Salman S, Alaswad, Khaldoon, Krestyaninov, Oleg, Khatri, Jaikirshan, Poommipanit, Paul, Jaffer, Farouc A, Choi, James, Patel, Mitul, Gorgulu, Sevket, Koutouzis, Michalis, Tsiafoutis, Ioannis, Sheikh, Abdul M, ElGuindy, Ahmed, Elbarouni, Basem, Patel, Taral, Jefferson, Brian, Wollmuth, Jason R, Yeh, Robert, Karmpaliotis, Dimitrios, Kirtane, Ajay J, McEntegart, Margaret B, Masoumi, Amirali, Davies, Rhian, Rangan, Bavana V, Mastrodemos, Olga C, Doshi, Darshan, Sandoval, Yader, Basir, Mir B, Megaly, Michael S, Ungi, Imre, Rafeh, Nidal Abi, Goktekin, Omer, and Brilakis, Emmanouil S

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Atherosclerosis, Cardiovascular, Heart Disease - Coronary Heart Disease, Heart Disease, percutaneous coronary intervention, chronic total occlusion, balloon uncrossable, Medical biochemistry and metabolomics, Medical biotechnology, Pharmacology and pharmaceutical sciences
Abstract

Background: Balloon uncrossable lesions are defined as lesions that cannot be crossed with a balloon after successful guidewire crossing. Methods: We analyzed the association between balloon uncrossable lesions and procedural outcomes of 8671 chronic total occlusions (CTOs) percutaneous coronary interventions (PCIs) performed between 2012 and 2022 at 41 centers. Results: The prevalence of balloon uncrossable lesions was 9.2%. The mean patient age was 64.2 ± 10 years and 80% were men. Patients with balloon uncrossable lesions were older (67.3 ± 9 vs. 63.9 ± 10, p < 0.001) and more likely to have prior coronary artery bypass graft surgery (40% vs. 25%, p < 0.001) and diabetes mellitus (50% vs. 42%, p < 0.001) compared with patients who had balloon crossable lesions. In-stent restenosis (23% vs. 16%. p < 0.001), moderate/severe calcification (68% vs. 40%, p < 0.001), and moderate/severe proximal vessel tortuosity (36% vs. 25%, p < 0.001) were more common in balloon uncrossable lesions. Procedure time (132 (90, 197) vs. 109 (71, 160) min, p < 0.001) was longer and the air kerma radiation dose (2.55 (1.41, 4.23) vs. 1.97 (1.10, 3.40) min, p < 0.001) was higher in balloon uncrossable lesions, while these lesions displayed lower technical (91% vs. 99%, p < 0.001) and procedural (88% vs. 96%, p < 0.001) success rates and higher major adverse cardiac event (MACE) rates (3.14% vs. 1.49%, p < 0.001). Several techniques were required for balloon uncrossable lesions. Conclusion: In a contemporary, multicenter registry, 9.2% of the successfully crossed CTOs were initially balloon uncrossable. Balloon uncrossable lesions exhibited lower technical and procedural success rates and a higher risk of complications compared with balloon crossable lesions.

Published
2023

3. Endovascular Treatment and Outcomes for Femoropopliteal In-Stent Restenosis: Insights from the XLPAD Registry

Author

Vu, Michael H, Sande-Docor, Glaiza-Mae, Liu, Yulun, Tsai, Shirling, Patel, Mitul, Metzger, Chris, Shishehbor, Mehdi H, Brilakis, Emmanouil S, Shammas, Nicolas W, Monteleone, Peter, and Banerjee, Subhash

Subjects
Clinical Research, Clinical Trials and Supportive Activities, Cardiovascular, Angioplasty, Balloon, Clinical Studies as Topic, Coated Materials, Biocompatible, Constriction, Pathologic, Coronary Restenosis, Femoral Artery, Humans, Peripheral Arterial Disease, Popliteal Artery, Registries, Treatment Outcome, Vascular Patency, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology
Abstract

BackgroundThere is limited "real-world" evidence examining treatment modalities and outcomes in patients with symptomatic peripheral arterial disease undergoing endovascular treatment of femoropopliteal (FP) in-stent restenosis (ISR).Materials and methodsWe compared outcomes in 2,895 patients from the XLPAD registry (NCT01904851) between 2006 and 2019 treated for FP ISR (n = 347) and non-ISR (n = 2,548) lesions. Primary endpoint included major adverse limb events (MALE) at 1 year, a composite of all-cause death, target limb repeat revascularization, or major amputation.ResultsISR patients were more frequently on antiplatelet (94.5% vs 89.4%, p=0.007) and statin (68.9% vs 60.3%, p=0.003) therapies. Lesion length was similar (ISR: 145 ± 99 mm vs. non-ISR: 142 ± 99 mm, p=0.55). Fewer treated ISR lesions were chronic total occlusions (47.3% vs. 53.7%, p=0.02) and severely calcified (22.4% vs. 44.7%, p < 0.001). Atherectomy (63.5% vs. 45.0%, p < 0.001) and drug-coated balloons (DCB; 4.7% vs. 1.7%, p < 0.001) were more frequently used in ISR lesions. The distal embolization rate was higher in ISR lesions (2.4% vs. 0.9%, p=0.02). Repeat revascularization (21.5% vs. 16.7%, p=0.04; Figure) was higher and freedom from MALE at 1 year was significantly lower (87% vs. 92.5%, p < 0.001) in the ISR group.ConclusionAtherectomy and DCB are more frequently used to treat FP ISR lesions. Patients with FP ISR have more intraprocedural distal embolization, higher repeat revascularization procedures, and lower freedom from MALE at 1 year.

Published
2022

6. Artificial Intelligence, Computational Simulations, and Extended Reality in Cardiovascular Interventions

Author

Samant, Saurabhi, Bakhos, Jules Joel, Wu, Wei, Zhao, Shijia, Kassab, Ghassan S., Khan, Behram, Panagopoulos, Anastasios, Makadia, Janaki, Oguz, Usama M., Banga, Akshat, Fayaz, Muhammad, Glass, William, Chiastra, Claudio, Burzotta, Francesco, LaDisa, John F., Jr., Iaizzo, Paul, Murasato, Yoshinobu, Dubini, Gabriele, Migliavacca, Francesco, Mickley, Timothy, Bicek, Andrew, Fontana, Jason, West, Nick E.J., Mortier, Peter, Boyers, Pamela J., Gold, Jeffrey P., Anderson, Daniel R., Tcheng, James E., Windle, John R., Samady, Habib, Jaffer, Farouc A., Desai, Nihar R., Lansky, Alexandra, Mena-Hurtado, Carlos, Abbott, Dawn, Brilakis, Emmanouil S., Lassen, Jens Flensted, Louvard, Yves, Stankovic, Goran, Serruys, Patrick W., Velazquez, Eric, Elias, Pierre, Bhatt, Deepak L., Dangas, George, and Chatzizisis, Yiannis S.

Published
2023
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10. Distal Target Vessel Quality and Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention

Author

Allana, Salman S., Kostantinis, Spyridon, Simsek, Bahadir, Karacsonyi, Judit, Rempakos, Athanasois, Alaswad, Khaldoon, Krestyaninov, Oleg, Khelimskiid, Dmitrii, Karmpaliotis, Dimitrios, Jaffer, Farouc A., Khatri, Jaikirshan J., Poommipanit, Paul, Patel, Mitul P., Mahmud, Ehtisham, Koutouzis, Michael, Tsiafoutis, Ioannis, Gorgulu, Sevket, Elbarouni, Basem, Nicholson, William, Jaber, Wissam, Rinfret, Stephane, Rafeh, Nidal Abi, Goktekin, Omer, ElGuindy, Ahmed M., Sandoval, Yader, Burke, M. Nicholas, Rangan, Bavana V., and Brilakis, Emmanouil S.

Published
2023
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11. International Psychological Well-Being Survey of Interventional Cardiologists

Author

Simsek, Bahadir, Rempakos, Athanasios, Kostantinis, Spyridon, Karacsonyi, Judit, Rangan, Bavana V., Mastrodemos, Olga C., Kirtane, Ajay J., Bortnick, Anna E., Jneid, Hani, Azzalini, Lorenzo, Milkas, Anastasios, Alaswad, Khaldoon, Linzer, Mark, Egred, Mohaned, Allana, Salman S., Rao, Sunil V., Sandoval, Yader, and Brilakis, Emmanouil S.

Published
2023
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12. 2-Year Outcomes After Stenting of Lipid-Rich and Nonrich Coronary Plaques

Author

Yamamoto, Myong Hwa, Maehara, Akiko, Stone, Gregg W, Kini, Annapoorna S, Brilakis, Emmanouil S, Rizik, David G, Shunk, Kendrick, Powers, Eric R, Tobis, Jonathan M, Maini, Brijeshwar S, Dixon, Simon R, Goldstein, James A, Petersen, John L, Généreux, Philippe, Shah, Priti R, Crowley, Aaron, Nicholls, Stephen J, Mintz, Gary S, Muller, James E, and Weisz, Giora

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Atherosclerosis, Bioengineering, Cardiovascular, Heart Disease, Heart Disease - Coronary Heart Disease, 4.2 Evaluation of markers and technologies, Detection, screening and diagnosis, Aged, Coronary Artery Disease, Drug-Eluting Stents, Female, Follow-Up Studies, Humans, Lipid Metabolism, Male, Middle Aged, Percutaneous Coronary Intervention, Plaque, Atherosclerotic, Prospective Studies, Registries, Spectroscopy, Near-Infrared, Treatment Outcome, intravascular ultrasound, lipid-rich plaque, near-infrared spectroscopy, stent, Cardiorespiratory Medicine and Haematology, Public Health and Health Services, Cardiovascular System & Hematology, Cardiovascular medicine and haematology
Abstract

BackgroundAutopsy studies suggest that implanting stents in lipid-rich plaque (LRP) may be associated with adverse outcomes.ObjectivesThe purpose of this study was to evaluate the association between LRP detected by near-infrared spectroscopy (NIRS) and clinical outcomes in patients with coronary artery disease treated with contemporary drug-eluting stents.MethodsIn this prospective, multicenter registry, NIRS was performed in patients undergoing coronary angiography and possible percutaneous coronary intervention (PCI). Lipid core burden index (LCBI) was calculated as the fraction of pixels with the probability of LRP >0.6 within a region of interest. MaxLCBI4mm was defined as the maximum LCBI within any 4-mm-long segment. Major adverse cardiac events (MACE) included cardiac death, myocardial infarction, definite or probable stent thrombosis, or unplanned revascularization or rehospitalization for progressive angina or unstable angina. Events were subcategorized as culprit (treated) lesion-related, nonculprit (untreated) lesion-related, or indeterminate.ResultsAmong 1,999 patients who were enrolled in the COLOR (Chemometric Observations of Lipid Core Plaques of Interest in Native Coronary Arteries Registry), PCI was performed in 1,621 patients and MACE occurred in 18.0% of patients, of which 8.3% were culprit lesion-related, 10.7% were nonculprit lesion-related, and 3.1% were indeterminate during 2-year follow-up. Complications from NIRS imaging occurred in 9 patients (0.45%), which resulted in 1 peri-procedural myocardial infarction and 1 emergent coronary bypass. Pre-PCI NIRS imaging was obtained in 1,189 patients, and the 2-year rate of culprit lesion-related MACE was not significantly associated with maxLCBI4mm (hazard ratio of maxLCBI4mm per 100: 1.06; 95% confidence interval: 0.96 to 1.17; p = 0.28) after adjusting clinical and procedural factors.ConclusionsFollowing PCI with contemporary drug-eluting stents, stent implantation in NIRS-defined LRPs was not associated with increased periprocedural or late adverse outcomes compared with those without significant lipid.

Published
2020

14. Periprocedural Mortality in Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From the PROGRESS-CTO Registry

Author

Simsek, Bahadir, Rempakos, Athanasios, Kostantinis, Spyridon, Karacsonyi, Judit, Gorgulu, Sevket, Alaswad, Khaldoon, Choi, James W., Jaffer, Farouc A., Doshi, Darshan, Poommipanit, Paul, Aygul, Nazif, Krestyaninov, Oleg, Khelimskii, Dmitrii, Uretsky, Barry, Davies, Rhian, Goktekin, Omer, ElGuindy, Ahmed, Jefferson, Brian K., Patel, Taral N., Patel, Mitul, Sheikh, Abdul, Karmpaliotis, Dimitri, Potluri, Srinivasa, Al-Azizi, Karim, Mastrodemos, Olga C., Rangan, Bavana V., Allana, Salman S., Sandoval, Yader, Burke, M. Nicholas, and Brilakis, Emmanouil S.

Published
2023
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16. A prospective observational study on impact of epinephrine administration route on acute myocardial infarction patients with cardiac arrest in the catheterization laboratory (iCPR study)

Author

Aldujeli, Ali, Haq, Ayman, Tecson, Kristen M., Kurnickaite, Zemyna, Lickunas, Karolis, Bailey, Som, Tatarunas, Vacis, Braukyliene, Rima, Baksyte, Giedre, Aldujeili, Montazar, Khalifeh, Hussein, Briedis, Kasparas, Ordiene, Rasa, Unikas, Ramunas, Hamadeh, Anas, and Brilakis, Emmanouil S.

Published
2022
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17. Drug-eluting stents versus bare-metal stents in saphenous vein grafts: a double-blind, randomised trial

Author

Brilakis, Emmanouil S, Edson, Robert, Bhatt, Deepak L, Goldman, Steven, Holmes, David R, Rao, Sunil V, Shunk, Kendrick, Rangan, Bavana V, Mavromatis, Kreton, Ramanathan, Kodangudi, Bavry, Anthony A, Garcia, Santiago, Latif, Faisal, Armstrong, Ehrin, Jneid, Hani, Conner, Todd A, Wagner, Todd, Karacsonyi, Judit, Uyeda, Lauren, Ventura, Beverly, Alsleben, Aaron, Lu, Ying, Shih, Mei-Chiung, Banerjee, Subhash, Investigators, DIVA Trial, Ahmed, Bina, Ratliff, D Michelle, Ricciardi, Mark, Sheldon, Mark, Icenogle, Milton, Snider, Richard, Ardati, Amer, Nallamothu, Brahmajee, Duvernoy, Claire, Menees, Daniel S, Gurm, Hitinder, Thomas, Michael P, Grossman, Paul, Owen, Kristine, Topaz, On, Kumar, Gautam, Block, Peter, Zidar, David A, Bezerra, Hiram, Goldberg, Jonathan, Ortiz, Jose, Jozic, Joseph, Osman, Mohammed, Rosenthal, Noah, Parikh, Sahil A, Lassar, Tom A, Chan, Albert, Kumar, Arun, Aggarwal, Kul, Cyrus, Tillmann, Grodin, Jerrold, Hattler, Brack, Casserly, Ivan, Messenger, John, Kim, Michael, Rogers, R Kevin, Waldo, Stephen, Tsai, Thomas, Morris, Kenneth, Krucoff, Mitchell, Rao, Sunil, Povsic, Thomas J, Jones, William S, Bavry, Anthony, Choi, Calvin, Park, Ki, Liu, Jayson, Kar, Biswajit, Paniagua, David, Breall, Jeffrey, Bolad, Islam, Mukerji, Rita, Subbarao, Roopa, Abdel-Latif, Ahmed, Booth, David C, Ziada, Khaled M, Rajan, Lawrence, Hakeem, Abdul, Uretsky, Barry F, Agrawal, Mayank, Sachdeva, Rajesh, Ahmed, Zubair, McGee, Jesse, Shah, Rahman, Sharma, Alok, McFalls, Edward, Siddiqui, Rizwan, and Adabag, Selcuk

Subjects
Cardiovascular, Bioengineering, Clinical Research, Heart Disease, Clinical Trials and Supportive Activities, Patient Safety, Assistive Technology, Atherosclerosis, Heart Disease - Coronary Heart Disease, Aged, Double-Blind Method, Drug-Eluting Stents, Female, Graft Rejection, Humans, Male, Middle Aged, Percutaneous Coronary Intervention, Saphenous Vein, Self Expandable Metallic Stents, Thrombosis, Treatment Outcome, DIVA Trial Investigators, Medical and Health Sciences, General & Internal Medicine
Abstract

BackgroundFew studies have examined the efficacy of drug-eluting stents (DES) for reducing aortocoronary saphenous vein bypass graft (SVG) failure compared with bare-metal stents (BMS) in patients undergoing stenting of de-novo SVG lesions. We assessed the risks and benefits of the use of DES versus BMS in de-novo SVG lesions.MethodsPatients were recruited to our double-blind, randomised controlled trial from 25 US Department of Veterans Affairs centres. Eligible participants were aged at least 18 years and had at least one significant de-novo SVG lesion (50-99% stenosis of a 2·25-4·5 mm diameter SVG) requiring percutaneous coronary intervention with intent to use embolic protection devices. Enrolled patients were randomly assigned, in a 1:1 ratio, by phone randomisation system to receive a DES or BMS. Randomisation was stratified by presence or absence of diabetes and number of target SVG lesions requiring percutaneous coronary intervention (one or two or more) within each participating site by use of an adaptive scheme intended to balance the two stent type groups on marginal totals for the stratification factors. Patients, referring physicians, study coordinators, and outcome assessors were masked to group allocation. The primary endpoint was the 12-month incidence of target vessel failure, defined as the composite of cardiac death, target vessel myocardial infarction, or target vessel revascularisation. The DIVA trial is registered with ClinicalTrials.gov, number NCT01121224.FindingsBetween Jan 1, 2012, and Dec 31, 2015, 599 patients were randomly assigned to the stent groups, and the data for 597 patients were used. The patients' mean age was 68·6 (SD 7·6) years, and 595 (>99%) patients were men. The two stent groups were similar for most baseline characteristics. At 12 months, the incidence of target vessel failure was 17% (51 of 292) in the DES group versus 19% (58 of 305) in the BMS group (adjusted hazard ratio 0·92, 95% CI 0·63-1·34, p=0·70). Between-group differences in the components of the primary endpoint, serious adverse events, or stent thrombosis were not significant. Enrolment was stopped before the revised target sample size of 762 patients was reached.InterpretationIn patients undergoing stenting of de-novo SVG lesions, no significant differences in outcomes between those receiving DES and BMS during 12 months of follow-up were found. The study results have important economic implications in countries with high DES prices such as the USA, because they suggest that the lower-cost BMS can be used in SVG lesions without compromising either safety or efficacy.FundingUS Department of Veterans Affairs Cooperative Studies Program.

Published
2018

18. Prevalence, Presentation and Treatment of ‘Balloon Undilatable’ Chronic Total Occlusions: Insights from a Multicenter US Registry

Author

Tajti, Peter, Karmpaliotis, Dimitri, Alaswad, Khaldoon, Toma, Catalin, Choi, James W, Jaffer, Farouc A, Doing, Anthony H, Patel, Mitul, Mahmud, Ehtisham, Uretsky, Barry, Karatasakis, Aris, Karacsonyi, Judit, Danek, Barbara A, Rangan, Bavana V, Banerjee, Subhash, Ungi, Imre, and Brilakis, Emmanouil S

Subjects
Heart Disease, Cardiovascular, Aged, Angioplasty, Balloon, Coronary, Chronic Disease, Coronary Angiography, Coronary Occlusion, Female, Humans, Male, Middle Aged, Prevalence, Registries, Risk Factors, Tomography, Optical Coherence, Treatment Failure, United States, chronic total occlusion, complex coronary intervention, percutaneous coronary intervention, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology
Abstract

BACKGROUND:The prevalence, treatment and outcomes of balloon undilatable chronic total occlusions (CTOs) have received limited study. METHODS:We examined the prevalence, clinical and angiographic characteristics, and procedural outcomes of percutaneous coronary interventions (PCIs) for balloon undilatable CTOs in a contemporary multicenter US registry. RESULTS:Between 2012 and 2017 data on balloon undilatable lesions were available for 425 consecutive CTO PCIs in 415 patients in whom guidewire crossing was successful: 52 of 425 CTOs were balloon undilatable (12%). Mean patient age was 65 ± 10 years and most patients were men (84%). Patients with balloon undilatable CTOs were more likely to be diabetic (67 vs. 41%, P

Published
2018

19. Impacto de la adherencia a un algoritmo híbrido para la selección de la estrategia inicial de cruce en la intervención coronaria percutánea de oclusiones crónicas

Author

Xenogiannis, Iosif, Alaswad, Khaldoon, Krestyaninov, Oleg, Khelimskii, Dmitrii, Khatri, Jaikirshan J., Choi, James W., Jaffer, Farouc A., Patel, Mitul, Mahmud, Ehtisham, Doing, Anthony H., Dattilo, Phil, Koutouzis, Michalis, Tsiafoutis, Ioannis, Uretsky, Barry, Jefferson, Brian K., Patel, Taral, Jaber, Wissam, Samady, Habib, Sheikh, Abdul M., Yeh, Robert W., Tamez, Hector, Elbarouni, Basem, Love, Michael P., Abi Rafeh, Nidal, Maalouf, Assaad, Fadi, Abou Jaoudeh, Toma, Catalin, Shah, Alpesh R., Chandwaney, Raj H., Omer, Mohamed, Megaly, Michael S., Vemmou, Evangelia, Nikolakopoulos, Ilias, Rangan, Bavana V., Garcia, Santiago, Abdullah, Shuaib, Banerjee, Subhash, Burke, M. Nicholas, Karmpaliotis, Dimitri, and Brilakis, Emmanouil S.

Published
2021
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22. Global Chronic Total Occlusion Crossing Algorithm: JACC State-of-the-Art Review

Author

Wu, Eugene B., Brilakis, Emmanouil S., Mashayekhi, Kambis, Tsuchikane, Etsuo, Alaswad, Khaldoon, Araya, Mario, Avran, Alexandre, Azzalini, Lorenzo, Babunashvili, Avtandil M., Bayani, Baktash, Behnes, Michael, Bhindi, Ravinay, Boudou, Nicolas, Boukhris, Marouane, Bozinovic, Nenad Z., Bryniarski, Leszek, Bufe, Alexander, Buller, Christopher E., Burke, M. Nicholas, Buttner, Achim, Cardoso, Pedro, Carlino, Mauro, Chen, Ji-Yan, Christiansen, Evald Hoej, Colombo, Antonio, Croce, Kevin, de los Santos, Felix Damas, de Martini, Tony, Dens, Joseph, di Mario, Carlo, Dou, Kefei, Egred, Mohaned, Elbarouni, Basem, ElGuindy, Ahmed M., Escaned, Javier, Furkalo, Sergey, Gagnor, Andrea, Galassi, Alfredo R., Garbo, Roberto, Gasparini, Gabriele, Ge, Junbo, Ge, Lei, Goel, Pravin Kumar, Goktekin, Omer, Gonzalo, Nieves, Grancini, Luca, Hall, Allison, Hanna Quesada, Franklin Leonardo, Hanratty, Colm, Harb, Stefan, Harding, Scott A., Hatem, Raja, Henriques, Jose P.S., Hildick-Smith, David, Hill, Jonathan M., Hoye, Angela, Jaber, Wissam, Jaffer, Farouc A., Jang, Yangsoo, Jussila, Risto, Kalnins, Artis, Kalyanasundaram, Arun, Kandzari, David E., Kao, Hsien-Li, Karmpaliotis, Dimitri, Kassem, Hussien Heshmat, Khatri, Jaikirshan, Knaapen, Paul, Kornowski, Ran, Krestyaninov, Oleg, Kumar, A.V. Ganesh, Lamelas, Pablo Manuel, Lee, Seung-Whan, Lefevre, Thierry, Leung, Raymond, Li, Yu, Li, Yue, Lim, Soo-Teik, Lo, Sidney, Lombardi, William, Maran, Anbukarasi, McEntegart, Margaret, Moses, Jeffrey, Munawar, Muhammad, Navarro, Andres, Ngo, Hung M., Nicholson, William, Oksnes, Anja, Olivecrona, Goran K., Padilla, Lucio, Patel, Mitul, Pershad, Ashish, Postu, Marin, Qian, Jie, Quadros, Alexandre, Rafeh, Nidal Abi, Råmunddal, Truls, Prakasa Rao, Vithala Surya, Reifart, Nicolaus, Riley, Robert F., Rinfret, Stephane, Saghatelyan, Meruzhan, Sianos, George, Smith, Elliot, Spaedy, Anthony, Spratt, James, Stone, Gregg, Strange, Julian W., Tammam, Khalid O., Thompson, Craig A., Toma, Aurel, Tremmel, Jennifer A., Trinidad, Ricardo Santiago, Ungi, Imre, Vo, Minh, Vu, Vu Hoang, Walsh, Simon, Werner, Gerald, Wojcik, Jaroslaw, Wollmuth, Jason, Xu, Bo, Yamane, Masahisa, Ybarra, Luiz F., Yeh, Robert W., and Zhang, Qi

Published
2021
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24. Abstract 12578: Development and Validation of a Scoring System For Predicting Technical Failure During Percutaneous Coronary Interventions of Chronic Total Occlusions: The Updated PROGRESS-CTO Score

Author

Karacsonyi, Judit, Simsek, Bahadir, Kostantinis, Spyridon, Alaswad, Khaldoon, Krestyaninov, Oleg, Khatri, Jai, Poommipanit, Paul, Gorgulu, Sevket, Jaffer, Farouc A, KUTUZIS, MICHAEL, Sheikh, Abdul, Jaber, Wissam, Rinfret, Stephane, Yeh, Robert, El Guindy, Ahmed, GOKTEKIN, OMER, Abi Rafeh, Nidal, Patel, Taral, jefferson, brian, Karmpaliotis, Dimitrios, Kirtane, Ajay, McEntegart, Margaret, Mastrodemos, Olga, Rangan, Bavana V, Ungi, Imre, Sandoval, Yader, Allana, Salman S, Burke, M Nicholas, and Brilakis, Emmanouil S

Published
2022
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25. Abstract 12133: Coronary Artery Perforation During Chronic Total Occlusion Percutaneous Coronary Intervention: Incidence, Mechanisms, Treatment and Outcomes

Author

Kostantinis, Spyridon, Simsek, Bahadir, Karacsonyi, Judit, Alaswad, Khaldoon, Krestyaninov, Oleg, Khelimskii, Dmitrii, Karmpaliotis, Dimitrios, Jaffer, Farouc A, Khatri, Jaikirshan, Poommipanit, Paul, Jaber, Wissam, Rinfret, Stephane, Nicholson, William, PATEL, MITUL P, Mahmud, Ehtisham, KUTUZIS, MICHAEL, Tsiafoutis, Ioannis, Benton, Stewart M, Jr, Davies, Rhian, Toma, Catalin, Kerrigan, Jimmy, Haddad, Elias, Abi Rafeh, Nidal, El Guindy, Ahmed, Goktekin, Omer, Mastrodemos, Olga, Rangan, Bavana V, Burke, M Nicholas, and Brilakis, Emmanouil S

Published
2022
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26. Abstract 11910: Contemporary In-Hospital Outcomes of Bifurcation Percutaneous Coronary Interventions: Update From the Prospective Global Registry for the Study of Bifurcation Lesion Interventions (PROGRESS-BIFURCATION)

Author

Simsek, Bahadir, Kostantinis, Spyridon, Karacsonyi, Judit, Vemmou, Evangelia, Nikolakopoulos, Ilias, assali, maen, Burke, M Nicholas, Garcia, Santiago, Wang, Yale, Goessl, Mario, Traverse, Jay, Poulose, Anil, Chavez, Ivan, Sorajja, Paul, Mooney, Michael R, Mastrodemos, Olga, Rangan, Bavana V, and Brilakis, Emmanouil S

Published
2022
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28. Abstract 11505: Predicting In-Hospital All-Cause Mortality in Chronic Total Occlusion Percutaneous Coronary Intervention: PROGRESS-CTO Mortality Score

Author

Simsek, Bahadir, Kostantinis, Spyridon, Karacsonyi, Judit, Alaswad, Khaldoon, Krestyaninov, Oleg, Khelimskii, Dmitrii, Davies, Rhian, GOKTEKIN, OMER, Gorgulu, Sevket, El Guindy, Ahmed, Chandwaney, Raj, PATEL, MITUL P, Karmpaliotis, Dimitrios, Khatri, Jaikirshan, Jaffer, Farouc A, Rangan, Bavana V, Sandoval, Yader, Choi, James, Nicholson, William, Jaber, Wissam, Rinfret, Stephane, KUTUZIS, MICHAEL, Tsiafoutis, Ioannis, Yeh, Robert W, Burke, M Nicholas, Allana, Salman S, Mastrodemos, Olga, and Brilakis, Emmanouil S

Published
2022
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29. Abstract 11496: Radial Access for Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From the PROGRESS-CTO Registry

Author

Simsek, Bahadir, Gorgulu, Sevket, Kostantinis, Spyridon, Karacsonyi, Judit, Alaswad, Khaldoon, Reddy, Niranjan, Jaffer, Farouc A, Doshi, Darshan, Khatri, Jaikirshan, Young, Laura, Poommipanit, Paul, GOKTEKIN, OMER, Krestyaninov, Oleg, Davies, Rhian, El Guindy, Ahmed, Kerrigan, Jimmy, PATEL, MITUL P, Elbarouni, Basem, Rinfret, Stephane, Jaber, Wissam, Nicholson, William, Dattilo, Philip, Abi Rafeh, Nidal, Rangan, Bavana V, Mastrodemos, Olga, Allana, Salman S, Burke, M Nicholas, KUTUZIS, MICHAEL, and Brilakis, Emmanouil S

Published
2022
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31. In-Stent CTO Percutaneous Coronary Intervention: Individual Patient Data Pooled Analysis of 4 Multicenter Registries

Author

Vemmou, Evangelia, Quadros, Alexandre S., Dens, Joseph A., Rafeh, Nidal Abi, Agostoni, Pierfrancesco, Alaswad, Khaldoon, Avran, Alexandre, Belli, Karlyse C., Carlino, Mauro, Choi, James W., El-Guindy, Ahmed, Jaffer, Farouc A., Karmpaliotis, Dimitri, Khatri, Jaikirshan J., Khelimskii, Dmitrii, Knaapen, Paul, La Manna, Alessio, Krestyaninov, Oleg, Lamelas, Pablo, Ojeda, Soledad, Padilla, Lucio, Pan, Manuel, Piccaro de Oliveira, Pedro, Rinfret, Stéphane, Spratt, James C., Tanabe, Masaki, Walsh, Simon, Nikolakopoulos, Ilias, Karacsonyi, Judit, Rangan, Bavana V., Brilakis, Emmanouil S., and Azzalini, Lorenzo

Published
2021
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34. Coronary artery spatial distribution of chronic total occlusions: Insights from a large US registry

Author

Garcia, Santiago, Alraies, M Chadi, Karatasakis, Aris, Yannopoulos, Demetris, Karmpaliotis, Dimitri, Alaswad, Khaldoon, Jaffer, Farouc A, Yeh, Robert W, Patel, Mitul P, Bahadorani, John, Karacsonyi, Judit, Kalsaria, Pratik, Danek, Barbara, Banerjee, Subhash, and Brilakis, Emmanouil S

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Heart Disease, Clinical Research, Cardiovascular, Heart Disease - Coronary Heart Disease, Aged, Chronic Disease, Collateral Circulation, Coronary Angiography, Coronary Circulation, Coronary Occlusion, Coronary Vessels, Female, Humans, Male, Middle Aged, Percutaneous Coronary Intervention, Plaque, Atherosclerotic, Predictive Value of Tests, Registries, Risk Factors, Rupture, Spontaneous, Time Factors, Treatment Outcome, United States, chronic total occlusion, percutaneous coronary intervention, coronary artery disease, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology, Cardiovascular medicine and haematology
Abstract

ObjectiveTo assess the spatial distribution of chronic total occlusions (CTOs) within the coronary arteries and describe procedural strategies and outcomes during CTO percutaneous coronary intervention (PCI).BackgroundAcute occlusions due to plaque rupture tend to cluster within the proximal third of the coronary artery.MethodsWe examined the clinical and procedural characteristics of 1,348 patients according to lesion location within the coronary tree.ResultsA total of 1,369 lesions in 1,348 patients (mean age 66 ± 10 years, 85% male) were included. CTO PCI of proximal segments (n = 633, 46%) was more common than of mid (n = 557, 41%) and distal segments (n = 179, 13%). Patients undergoing CTO PCI of proximal segments were more likely to be smokers (P

Published
2017

39. Retrograde Chronic Total Occlusion Percutaneous Coronary Intervention via Saphenous Vein Graft

Author

Xenogiannis, Iosif, Gkargkoulas, Fotis, Karmpaliotis, Dimitri, Krestyaninov, Oleg, Khelimskii, Dmitrii, Jaffer, Farouc A., Khatri, Jaikirshan J., Kandzari, David E., Wyman, R. Michael, Doing, Anthony H., Dattilo, Phil, Toma, Catalin, Yeh, Robert W., Tamez, Hector, Choi, James W., Jaber, Wissam, Samady, Habib, Sheikh, Abdul M., Potluri, Srinivasa, Patel, Mitul, Mahmud, Ehtisham, Elbaruni, Basem, Love, Michael P., Koutouzis, Michalis, Tsiafoutis, Ioannis, Jefferson, Brian K., Patel, Taral, Uretsky, Barry, Moses, Jeffrey W., Lembo, Nicholas J., Parikh, Manish, Kirtane, Ajay J., Ali, Ziad A., Hall, Allison B., Megaly, Michael S., Vemmou, Evangelia, Nikolakopoulos, Ilias, Rangan, Bavana V., Morley, Pamela W., Bou Dargham, Bassel, Abdullah, Shuaib, Garcia, Santiago, Banerjee, Subhash, Burke, M. Nicholas, Brilakis, Emmanouil S., and Alaswad, Khaldoon

Published
2020
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40. Development and Validation of a Scoring System for Predicting Periprocedural Complications During Percutaneous Coronary Interventions of Chronic Total Occlusions: The Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS CTO) Complications Score

Author

Danek, Barbara Anna, Karatasakis, Aris, Karmpaliotis, Dimitri, Alaswad, Khaldoon, Yeh, Robert W, Jaffer, Farouc A, Patel, Mitul P, Mahmud, Ehtisham, Lombardi, William L, Wyman, Michael R, Grantham, J Aaron, Doing, Anthony, Kandzari, David E, Lembo, Nicholas J, Garcia, Santiago, Toma, Catalin, Moses, Jeffrey W, Kirtane, Ajay J, Parikh, Manish A, Ali, Ziad A, Karacsonyi, Judit, Rangan, Bavana V, Thompson, Craig A, Banerjee, Subhash, and Brilakis, Emmanouil S

Subjects
Patient Safety, Age Factors, Aged, Chronic Disease, Coronary Angiography, Coronary Occlusion, Female, Humans, Intraoperative Complications, Logistic Models, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Percutaneous Coronary Intervention, Postoperative Complications, ROC Curve, Registries, Reproducibility of Results, Risk Assessment, chronic total occlusion, complication, outcome, percutaneous coronary intervention, risk stratification, Cardiorespiratory Medicine and Haematology
Abstract

High success rates are achievable for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) using the hybrid approach, but periprocedural complications remain of concern. Although scores estimating success and efficiency in CTO PCI have been developed, there is currently no available score for estimation of the risk for periprocedural complications. We sought to develop a scoring tool for prediction of periprocedural complications during CTO PCI. We analyzed data from 1569 CTO PCIs in the Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS CTO) using a derivation and validation sampling ratio of 2:1. Variables independently associated with periprocedural complications in multivariable analysis in the derivation set were assigned points based on their respective odds ratios. Forty-four (2.8%) patients experienced complications. Three factors were independent predictors of complications and were included in the score: patient age >65 years, +3 points (odds ratio, OR=4.85, CI 1.82-16.77); lesion length ≥23 mm, +2 points (OR=3.22, CI 1.08-13.89); and use of the retrograde approach +1 point (OR=2.41, CI 1.04-6.05). The resulting score showed good calibration and discriminatory capacity in the derivation (Hosmer-Lemeshow χ2 6.271, P=0.281, receiver-operating characteristic [ROC] area=0.758) and validation (Hosmer-Lemeshow χ2 4.551, P=0.473, ROC area=0.793) sets. Score values of 0 to 2, 3 to 4, and ≥5 were defined as low, intermediate, and high risk of complications (derivation cohort 0.4%, 1.8%, 6.5%, P

Published
2016

41. Use of Intravascular Imaging During Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Contemporary Multicenter Registry

Author

Karacsonyi, Judit, Alaswad, Khaldoon, Jaffer, Farouc A, Yeh, Robert W, Patel, Mitul, Bahadorani, John, Karatasakis, Aris, Danek, Barbara A, Doing, Anthony, Grantham, J Aaron, Karmpaliotis, Dimitri, Moses, Jeffrey W, Kirtane, Ajay, Parikh, Manish, Ali, Ziad, Lombardi, William L, Kandzari, David E, Lembo, Nicholas, Garcia, Santiago, Wyman, Michael R, Alame, Aya, Nguyen‐Trong, Phuong‐Khanh J, Resendes, Erica, Kalsaria, Pratik, Rangan, Bavana V, Ungi, Imre, Thompson, Craig A, Banerjee, Subhash, and Brilakis, Emmanouil S

Subjects
Biomedical Imaging, Heart Disease, Heart Disease - Coronary Heart Disease, Cardiovascular, Aged, Chronic Disease, Coronary Angiography, Coronary Occlusion, Female, Humans, Male, Multimodal Imaging, Percutaneous Coronary Intervention, Registries, Tomography, Optical Coherence, Ultrasonography, Interventional, chronic total occlusion, intravascular ultrasound, optical coherence tomography, percutaneous coronary intervention, Cardiorespiratory Medicine and Haematology
Abstract

Intravascular imaging can facilitate chronic total occlusion (CTO) percutaneous coronary intervention. We examined the frequency of use and outcomes of intravascular imaging among 619 CTO percutaneous coronary interventions performed between 2012 and 2015 at 7 US centers. Mean age was 65.4±10 years and 85% of the patients were men. Intravascular imaging was used in 38%: intravascular ultrasound in 36%, optical coherence tomography in 3%, and both in 1.45%. Intravascular imaging was used for stent sizing (26.3%), stent optimization (38.0%), and CTO crossing (35.7%, antegrade in 27.9%, and retrograde in 7.8%). Intravascular imaging to facilitate crossing was used more frequently in lesions with proximal cap ambiguity (49% versus 26%, P

Published
2016

42. Contrast Utilization During Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Contemporary Multicenter Registry.

Author

Christakopoulos, Georgios E, Karmpaliotis, Dimitri, Alaswad, Khaldoon, Yeh, Robert W, Jaffer, Farouc A, Wyman, R Michael, Lombardi, William, Grantham, J Aaron, Kandzari, David A, Lembo, Nicholas, Moses, Jeffrey W, Kirtane, Ajay, Parikh, Manish, Green, Philip, Finn, Matthew, Garcia, Santiago, Doing, Anthony, Patel, Mitul, Bahadorani, John, Christopoulos, Georgios, Karatasakis, Aris, Thompson, Craig A, Banerjee, Subhash, and Brilakis, Emmanouil S

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Cardiovascular, Heart Disease, Heart Disease - Coronary Heart Disease, Aged, Contrast Media, Coronary Angiography, Coronary Occlusion, Drug Utilization Review, Drug-Related Side Effects and Adverse Reactions, Female, Humans, Intraoperative Care, Kidney Diseases, Male, Middle Aged, Percutaneous Coronary Intervention, Registries, United States, percutaneous coronary intervention, chronic total occlusion, contrast volume, radiation, complications, air kerma, fluoroscopy, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology, Cardiovascular medicine and haematology
Abstract

BackgroundAdministration of a large amount of contrast volume during chronic total occlusion (CTO) percutaneous coronary intervention (PCI) may lead to contrast-induced nephropathy.MethodsWe examined the association of clinical, angiographic and procedural variables with contrast volume administered during 1330 CTO-PCI procedures performed at 12 experienced United States centers.ResultsTechnical and procedural success was 90% and 88%, respectively, and mean contrast volume was 289 ± 138 mL. Approximately 33% of patients received >320 mL of contrast (high contrast utilization group). On univariable analysis, male gender (P=.01), smoking (P=.01), prior coronary artery bypass graft surgery (P=.04), moderate or severe calcification (P=.01), moderate or severe tortuosity (P=.04), proximal cap ambiguity (P=.01), distal cap at a bifurcation (P

Published
2016

44. Three dimensional reconstruction of coronary artery stents from optical coherence tomography: experimental validation and clinical feasibility

Author

Wu, Wei, Khan, Behram, Sharzehee, Mohammadali, Zhao, Shijia, Samant, Saurabhi, Watanabe, Yusuke, Murasato, Yoshinobu, Mickley, Timothy, Bicek, Andrew, Bliss, Richard, Valenzuela, Thomas, Iaizzo, Paul A., Makadia, Janaki, Panagopoulos, Anastasios, Burzotta, Francesco, Samady, Habib, Brilakis, Emmanouil S., Dangas, George D., Louvard, Yves, Stankovic, Goran, Dubini, Gabriele, Migliavacca, Francesco, Kassab, Ghassan S., Edelman, Elazer R., Chiastra, Claudio, and Chatzizisis, Yiannis S.

Published
2021
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45. Patient-specific computational simulation of coronary artery bifurcation stenting

Author

Zhao, Shijia, Wu, Wei, Samant, Saurabhi, Khan, Behram, Kassab, Ghassan S., Watanabe, Yusuke, Murasato, Yoshinobu, Sharzehee, Mohammadali, Makadia, Janaki, Zolty, Daniel, Panagopoulos, Anastasios, Burzotta, Francesco, Migliavacca, Francesco, Johnson, Thomas W., Lefevre, Thierry, Lassen, Jens Flensted, Brilakis, Emmanouil S., Bhatt, Deepak L., Dangas, George, Chiastra, Claudio, Stankovic, Goran, Louvard, Yves, and Chatzizisis, Yiannis S.

Published
2021
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48. Procedural Outcomes of Percutaneous Coronary Interventions for Chronic Total Occlusions Via the Radial Approach: Insights From an International Chronic Total Occlusion Registry

Author

Tajti, Peter, Alaswad, Khaldoon, Karmpaliotis, Dimitri, Jaffer, Farouc A., Yeh, Robert W., Patel, Mitul, Mahmud, Ehtisham, Choi, James W., Burke, M. Nicholas, Doing, Anthony H., Dattilo, Phil, Toma, Catalin, Smith, A.J. Conrad, Uretsky, Barry F., Holper, Elizabeth, Potluri, Srinivasa, Wyman, R. Michael, Kandzari, David E., Garcia, Santiago, Krestyaninov, Oleg, Khelimskii, Dmitrii, Koutouzis, Michalis, Tsiafoutis, Ioannis, Khatri, Jaikirshan J., Jaber, Wissam, Samady, Habib, Jefferson, Brian, Patel, Taral, Abdullah, Shuaib, Moses, Jeffrey W., Lembo, Nicholas J., Parikh, Manish, Kirtane, Ajay J., Ali, Ziad A., Doshi, Darshan, Xenogiannis, Iosif, Stanberry, Larissa I., Rangan, Bavana V., Ungi, Imre, Banerjee, Subhash, and Brilakis, Emmanouil S.

Published
2019
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