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Clouds continue to pose challenges to predict weather, climate and renewable energy due partly to knowledge gaps in microphysics-turbulence interactions. Particle-resolved direct numerical simulations (PR-DNS) that not only resolve the smallest turbulent eddies but also track growing histories of individual particles arguably constitute a fundamental tool to address the special challenges facing microphysics-turbulence interactions in clouds. This study consists of two parts. First, a major bottleneck issue of existing PR-DNS models is the small model domain size (e.g., less or about 1m3) due to high computational cost, which is smaller than many energy-containing eddies and typical grid sizes of large-eddy simulation (LES) models. We will introduce our HPC/AI accelerated PR-DNS model that aims to simulate a domain size of ~ 103m3 to address this computational challenge. Second, we will apply this PR-DNS to investigate three outstanding microphysics-turbulence problems: stochastic condensation/evaporation, turbulent entrainment-mixing, and droplet clustering. Results under different turbulence intensity (e.g., energy dissipation rate), environment conditions (e.g., relative humidity), and microphysical properties (e.g., initial droplet concentration and spectral shape of cloud droplet size distributions) will be analyzed. Also explored will be the role of turbulence-induced supersaturation fluctuations in determining aerosol activation into cloud droplets and droplet deactivation into aerosol particles. The AI/HPC accelerated PR-DNS further allows for examination of dependence of the results on the DNS domain size (or Reynolds number), by running the model with the domain spanning over several order of magnitudes (linear dimension varying from a few centimeters to about 10 meter)., The 28th IUGG General Assembly (IUGG2023) (Berlin 2023)

Introduction: In seminal trials of venous thromboembolism (VTE) treatment with direct oral anticoagulants (DOAC), few patients were enrolled at low and high body weights to estimate treatment effects in these subgroups. Consensus statements have recommended against use of DOACs in VTE for patients ≥120 kg. We sought to describe real-world use of DOACs and other anticoagulants for VTE across the weight spectrum. Methods: We performed a retrospective cohort study of patients with first-time VTE that were treated with anticoagulants in the VA health care system from 2008 to 2018. We excluded patients with 1) additional indications for anticoagulation (atrial fibrillation and mechanical valves) and 2) no documented weight in the 90 days prior to 90 days after index VTE. We stratified patients by weight ( Results: After excluding 3,676 patients with missing weight, there were 111,774 patients with VTE (64±13 years, 6% female). The most common therapy was warfarin (66%), followed by DOAC (21%), and LMWH/F only (13%). Median weight was 92 kg (interquartile range: 28), with 13,753 patients (12%) with weight ≥120 kg. Across weight categories, proportion of patients receiving DOAC was similar. In patients ≥120 kg, after multivariate adjustment, multiple comorbidities were associated with warfarin prescription while chronic kidney disease was associated with DOAC prescription ( Table ). Conclusion: Weight ≥120 kg is common for VTE patients, with DOAC frequently prescribed despite consensus statements recommending DOAC avoidance. For patients ≥120 kg, comorbidities influence VTE treatment selection, and determination of optimal treatment strategies across the spectrum of comorbidities is needed.

This paper reports the unique microstructure of polyurea foams that combines the advantages of open and closed cell polymeric foams, which were synthesized through a self-foaming process. The latter was the result of aggressive mechanical mixing of diamine curative, isocyanate, and deionized water at ambient conditions, which can be adjusted on-demand to produce variable density polyurea foam. The spherical, semi-closed microcellular structure has large perforations on the cell surface resulting from the concurrent expansion of neighboring cells and small holes at the bottom surface of the cells. This resulted in a partially perforated microcellular structure of polyurea foam. As a byproduct of the manufacturing process, polyurea microspheres nucleate and deposit on the inner cell walls of the foam, acting as a reinforcement. Since cell walls and the microspheres are made of polyurea, the resulting reinforcement effect overcomes the fundamental interfacial issue of different adjacent materials. The partially perforated, self-reinforced polyurea foam is compared to the performance of traditional counterparts in biomechanical impact scenarios. An analytical model was developed to explicate the stiffening effect associated with the reinforcing microspheres. The model results indicate that the reinforced microcell exhibited, on average, ~30% higher stiffness than its barren counterpart.

A stent in artery is subjected to significant mechanical loads due to the repetitive cyclical pressure loads and displacement of the artery wall. The arteries expands and contracts slightly as the pressure changes with the heart beat for long-term in-vivo service. The structure of the stent has to withstand these loads while scaffolding the narrow artery. Many different stent designs and materials have been studied. In our previous study [Alargasamy et. al. Mechanical properties of High Entropy Alloy Al0.1CoCrFeNi for Peripheral Vascular Stent Application, Cardiovascular Engineering and Technology] mechanical properties of High Entropy Alloy (HEA) are determined experimentally, the one to one comparison of these HEAs with stainless steel 316L was done. In this study in order to understand the behavior of HEA materials in actual stent implant application, the operation is simulated compuationally, using ANSYS Workbench, by applying stainless steel 316L and high entropy alloy properties as the material properties for the 3D stent model.

Background— The Radiation Reduction During Cardiac Catheterization Using Real-Time Monitoring study sought to examine the effect of a radiation detection device that provides real-time operator dose reporting through auditory feedback (Bleeper Sv; Vertec Scientific Ltd; Berkshire, UK) on patient dose and operator exposure during cardiac catheterization. Methods and Results— Between January 2012 and May 2014, 505 patients undergoing coronary angiography, percutaneous coronary intervention, or both were randomized to use (n=253) or no use (n=252) of the Bleeper Sv radiation monitor. Operator radiation exposure was measured in both groups using a second, silent radiation exposure monitoring device. Mean patient age was 65±8 years, most patients (99%) were men, and 30% had prior coronary artery bypass graft surgery. Baseline clinical characteristics were similar in the 2 study groups. Radial access was used in 18% and chronic total occlusion percutaneous coronary intervention constituted 7% of the total procedures. Median procedure time was 17 (12–27) minutes for diagnostic angiography, 42 (28–70) minutes for percutaneous coronary intervention, and 27 (14–51) minutes in the overall study population, with similar distribution between the study groups. First (9 [4–17] versus 14 [7–25] μSv; P P Conclusions— Use of a real-time radiation monitoring device that provides auditory feedback can significantly reduce operator radiation exposure during cardiac catheterization. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01510353.

Endovascular intervention has become a well-recognized treatment modality for peripheral artery disease; however, mid- and long-term outcomes have been plagued by limited durability. Plain balloon angioplasty and bare-metal stents have historically suffered from high restenosis rates leading to the need for frequent repeat revascularization procedures. The innovation of locally administered, drug-delivering balloons and stents has been a direct result of technological innovations directed toward prevention and treatment of this limitation. Over the last 5 years, numerous clinical trials investigating the use of drug-coated stents and drug-coated balloons indicate a significant improvement in endovascular treatment durability and outcomes. This review provides an up-to-date assessment of the current evidence for the use of drug-coated stents and drug-coated balloons in the treatment of femoropopliteal and infrapopliteal peripheral artery disease. Additionally, it provides an overview of the development of this technology, highlights landmark ongoing and completed clinical trials, examines evidence to support the use of drug-coated technologies in combination with other modalities, and examines promising new technological developments. Last, it summarizes the challenges and safety concerns that have delayed U.S. Food and Drug Administration approval of these devices.

Background Long-term outcome after bifurcation stenting with drug-eluting stents (DES) for obstructive coronary artery disease is poorly understood. In this study, we report 6–9-month angiographic follow-up and long-term clinical outcomes after implantation of drug-eluting stents by crush and kissing stent technique for coronary bifurcation lesions. Methods Consecutive patients undergoing bifurcation stenting with DES by crush or kissing stent technique were enrolled in a prospective registry. Angiographic follow-up was obtained at 6–9 months and clinical follow-up completed for a median of 38 months. Results A total of 86 patients participated in the study. Bifurcation stenting by crush technique was performed in 73 (85%) and by kissing stent in 13 (15%) patients. Stenting of left main bifurcation was applied in 24 (28%) patients. Angiographic follow-up was completed in 75 (87%) patients and showed restenosis in the main for 8 (11%) and side branch for 20 (27%) patients. Clinical follow-up was available for a median duration of 38 months. During follow-up, 2 (2%) patients died, 4 (5%) experienced myocardial infarction (MI), and 11 (13%) underwent target vessel revascularization (TVR) with an overall major adverse cardiac event (MACE) rate of 16%. In left main cohort, angiographic restenosis occurred in 9 (37%) patients, and 3 (12%) patients required TVR. There were no deaths or stent thrombosis. A comparison of crush and kissing stent technique showed significantly higher angiographic restenosis with crush (26% vs 13% in kissing stent patients, P = 0.046) and 95% of restenosis in crush group involved ostium of the side branch. There was no difference in clinical outcomes between the crush and kissing stent groups. Final kissing balloon dilatation (FKB) was successful in 65 (89%) patients in the crush group and associated with a significant reduction in MACE (8% in FKB successful vs 37% in FKB unsuccessful, P = 0.04) during follow-up. Conclusion Bifurcation stenting with crush or kissing stent technique is safe and associated with a low rate of TLR and MACE on long-term follow-up. Crush stenting is associated with a significantly higher rate of side branch restenosis compared to kissing stent technique. FKB is associated with significant reduction in MACE during follow-up. (J Interven Cardiol 2013;26:145–152)

The risk of distal embolization (DE) during infrainguinal peripheral artery interventions (PAI) is often mitigated by the use of embolic protection devices. There are limited data on the use of filters with the Jetstream (JS) atherectomy device, a rotational cutter with aspiration capacity. The Nav-6 filter is uniquely suited for use with the JS due to its wire compatibility and detachment from the filter; however, data on the off-label use of this combination have not been reported.Consecutive patients between October 2008 and April 2015 undergoing endovascular infrainguinal PAI with JS were analyzed as part of the Excellence in Peripheral Artery Disease (XL-PAD) registry (NCT01904851). Patients were divided into two subgroups with Nav-6 filter use vs no filter use. Descriptive and univariate analyses were performed.Among 141 patients (mean age, 67.8 ± 10.8 years; 169 lesions) included in this study, the Nav-6 filter was used in 82 (59%). Use of a filter was more frequent in longer lesions (146 ± 106 mm vs 91 ± 72 mm; P=.01), in more severe stenoses (95% vs 87%; P=.04), and in chronic total occlusions (33% vs 8.3%; P=.01). Patients receiving filters had longer procedure duration (102 ± 51 min vs 66 ± 41 min; P=.01) and longer fluoroscopy times (31 ± 16 min vs 21 ± 10 min; P.001). Use of the Nav-6 filter with the JS during PAI was associated with numerically lower rates of DE (1.8% vs 8%; P=.10) and similar rates of death and amputation. At 12 months, the target-lesion revascularization rate was higher in the filter group (22% vs 2.7%; P=.02), likely secondary to use of the filter in more complex lesions.Nav-6 filter during JS atherectomy was predominantly used during complex infrainguinal PAI and was associated with less occurrence of DE.

Introduction: There is limited data on outcomes of percutaneous endovascular intervention for lower extremity peripheral artery disease (PAD) in patients with diabetes mellitus (DM). We assessed the hypothesis that patients with DM, in comparison to patients without DM, have higher rates of major adverse cardiovascular and limb events after lower extremity PAD stenting. Methods: 1,006 patients with primary stent implant procedures between January 2005 and October 2015 enrolled in the observational XLPAD registry (NCT01904851) were analyzed for 12 month major adverse cardiovascular events (MACE; all-cause death, myocardial infarction, and stroke) and major adverse limb events (MALE; target limb repeated endovascular intervention, surgical revascularization, and major amputation). Cochran-Mantel-Haenszel statistics was used for overall association of categorical baseline characteristics; Cox proportional regressions and Kaplan-Meier curves were used for median time to event analysis. Results: At baseline, patients with DM had higher prevalence of coronary artery disease (74.9% vs. 56.2%; pFigure 1A ) as well as MALE (49.0% vs. 40.9%; HR 1.22; 95% CI 1.01-1.48; p=0.043, Figure 1B ) in patients with DM at 12-months. Conclusion: PAD in patients with DM is associated with significantly higher rates of major adverse cardiovascular and limb events.

The aim of this study was to assess actual procedural costs and outcomes comparing wire-catheter and dedicated chronic total occlusion (CTO) device strategies to cross peripheral artery CTOs.Peripheral artery CTO interventions are frequently performed, but there are limited data on actual procedural costs and outcomes comparing wire-catheter and dedicated CTO devices.The XLPAD (Excellence in Peripheral Artery Disease Intervention) registry (NCT01904851) was accessed to retrospectively compare cost and 30-day and 12-month outcomes of wire-catheter and crossing device strategies for treatment of infrainguinal peripheral artery CTO.Of all 3,234 treated lesions, 42% (n = 1,362) were CTOs in 1,006 unique patients. Wire-catheter approaches were used in 82% of CTOs, whereas dedicated CTO devices were used in 18% (p 0.0001). CTO crossing device use was associated with significantly higher technical success (74% vs. 65%; p 0.0001) and mean procedure cost ($7,800.09 vs. $4,973.24; p 0.0001). Because 12-month repeat revascularization (11.3% vs. 17.2%; p = 0.02) and amputation rates (2.8% vs. 8.5%; p = 0.002) in the CTO crossing device arm were lower compared with the wire-catheter group, the net cost for an initial CTO crossing device strategy was $423.80 per procedure.An initial wire-catheter approach to cross a peripheral artery CTO is most frequently adopted. The use of dedicated CTO crossing devices provides significantly higher technical success and lower reintervention and amputation rates, at a net cost of $423.80 per procedure at 12 months.

Background: Metformin is associated with improved skeletal muscle glucose uptake and improves skeletal muscle energetics. There is limited data of the impact of metformin us on need for repeat revascularization in patients with symptomatic peripheral artery disease (PAD) treated with endovascular revascularization. Methods: We compared need for vessel revascularization (TLR) rates in patients with diabetes mellitus (DM) treated with metformin and without, to non-DM enrolled in the Excellence in Peripheral Artery Disease (XLPAD) registry (NCT01904851) between 2006 and 2015. Results: In the study cohort of 2140 interventional procedures, 57.4% were performed in DM (n=268 on metformin and n=961 not on metformin). Frequency of hypertension, hyperlipidemia and chronic kidney disease was higher in DM not on metformin compared to DM on metformin (p Conclusions: Metformin therapy in symptomatic PAD patients with DM following endovascular revascularization is associated with improved survival and lower need for repeat revascularization compared to diabetics not treated with metformin.

The risk of distal embolization (DE) during infrainguinal peripheral artery interventions (PAI) is often mitigated with the use of embolic protection devices. There is limited data on the use of filters with the Jetstream (JS) atherectomy device, a rotational cutter with aspiration capacity. The Nav

Objectives The purpose of this study was to characterize clopidogrel hypersensitivity and describe its successful management with oral steroids without clopidogrel discontinuation. Background Hypersensitivity reactions to clopidogrel are poorly understood and present difficulty in management. Methods Patients diagnosed with clopidogrel hypersensitivity after percutaneous coronary intervention underwent evaluation and received oral prednisone without clopidogrel discontinuation. Cutaneous testing was performed after completion of clopidogrel therapy for diagnosis and assessment of cross-reactivity. Results Sixty-two patients representing 1.6% of the percutaneous coronary intervention population developed clopidogrel hypersensitivity during the study period. The mean age was 62 ± 11 years, 71% of patients were male, and 35% reported prior adverse drug reaction. Clopidogrel hypersensitivity manifested as generalized exanthema in 79%, localized skin reaction in 16%, and angioedema or urticaria in 5% of patients. Biopsy of affected areas demonstrated a lymphocyte-mediated delayed hypersensitivity reaction. Complete resolution of hypersensitivity reaction was observed in 61 patients (98%) with a short course of oral prednisone. Cutaneous testing confirmed delayed hypersensitivity reaction to clopidogrel in 34 (81%) and immediate hypersensitivity in 3 of 42 patients (7%) tested. Allergenic cross-reactivity was observed for ticlopidine in 10 (24%), prasugrel in 7 (17%), and both ticlopidine and prasugrel in 3 patients (7%). Histological examination showed lymphocyte-mediated hypersensitivity in abnormal patch test areas. Conclusions Clopidogrel hypersensitivity is manifested as generalized exanthema and is caused by a lymphocyte-mediated delayed hypersensitivity in most patients. This can be managed with oral steroids without clopidogrel discontinuation. Allergenic cross-reactivity with ticlopidine, prasugrel, or both is present in a significant number of patients with clopidogrel hypersensitivity.

In this project we study the SM background to new particles beyond the SM, in the dijet mass distribution. We are producing the same SM background by two different event generators (Madgraph+Herwig and Pythia stand-alone) at 13TeV and comparing their properties.

Chronic total occlusions (CTOs) are reported in up to 40% of patients with symptomatic peripheral arterial disease. The Viance Crossing catheter (Covidien) and the CrossBoss catheter (Boston Scientific) are novel devices that facilitate either true lumen or subintimal navigation across CTOs. The purpose of this study was to examine the acute procedural success of these devices for popliteal and below-the-knee (BTK) CTOs.Clinical and procedural outcome data between Sept 2010 and October 2013 were analyzed from the ongoing multicenter XLPAD registry. Technical success was defined as true lumen passage of the catheter, while procedural success was defined as successful vessel revascularization inclusive of subintimal passage and reentry.Twenty-nine patients underwent 31 procedures, in which 37 lesions were treated with the Viance and CrossBoss catheters. Mean age of the group was 69.1 ± 10.7 years and 26 patients were male (90%). All patients (100%) had hypertension, 62% were diabetic, and 48% were active smokers. Critical limb ischemia was the indication for the procedure in 58% of cases; mean Rutherford class was 4.2 ± 1.2 for the entire cohort. Target CTOs included 14 anterior tibial, 9 posterior tibial, 5 peroneal, 1 tibio-peroneal trunk, and 8 popliteal artery lesions. Mean lesion length was 81 ± 64 mm; 15 lesions (41%) were severely calcified. True lumen passage was obtained in 24 lesions (65% technical success). Subintimal entry was achieved in 5 lesions (14%). Procedural success was achieved in 26 lesions (70%). Procedural failure was related to longer lesion length (P.001), and mean length of failed lesions was 136 ± 65 mm.Viance and CrossBoss catheters were associated with an overall 70% procedural success with predominantly true lumen crossing in a BTK-CTO cohort. CTO length remains an important determinant of device success.

There are limited data regarding contemporary use of stent and non-stent based treatment strategies of infrainguinal peripheral artery disease (PAD).We analyzed data from the ongoing multicenter XLPAD registry between July 2005 and October 2013 to report on the use of non-stent (atherectomy ± balloon angioplasty) and stent-based treatment of superficial femoral artery (SFA), popliteal, and below-the-knee (BTK) vessels in contemporary clinical practice.A total of 584 interventions (SFA, 82.5%; popliteal, 7.2%; BTK, 9.9%) were performed in 372 patients (mean age, 63.2 years; diabetes mellitus, 57.7%; Rutherford category 1-3, 73.5%; Rutherford category 4-6, 20.1%). Stents were deployed in 389 lesions (66.6%; SFA, 90.5%; popliteal, 5.1%; BTK, 4.1%) and non-stent strategy (atherectomy, 49%) in 195 lesions (33.4%; SFA, 66.7%; popliteal, 11.3%; BTK, 21.5%). In the stent and non-stent groups, mean lesion lengths were 133.9 mm and 86.0 mm (P.001), chronic total occlusions (CTOs) constituted 63.0% and 49.7% (P.01), and restenotic lesions were 12.6% and 32.3% (P.001), respectively. At a mean follow-up of 260 ± 130 days, in the stent and non-stent treated patients, all-cause mortality was 4.3% and 3.5% (P=.65), clinically indicated repeat revascularization was 17.5% and 14.9% (P=.42), and amputation was 4.6% and 9.2% (P.01), respectively. SFA lesion location, long lesion length, and CTO were associated with the use of stents. Advanced Rutherford class was associated with a non-stent treatment strategy.The majority of endovascular peripheral arterial interventions are performed in the SFA; most include a CTO and in patients with diabetes mellitus. Operators use stents to primarily treat complex SFA lesions with overall similar outcomes, except for fewer amputations compared to a non-stent strategy.

The Smart Grid (SG) is the next-generation electrical power grid. It aims to provide reliable and efficient energy distribution and consumption by utilising information and communications technologies. At the core of the SG is the integration of communications networks with the power grid. However, the bottleneck issue in these networks is the last mile connection, which means connecting the substations and customer premises to the backhaul communications network via the so-called last mile access networks, referred to as SG access networks. Due to the wide coverage of these networks, spanning both the distribution and transmission levels of the power grid, they will incorporate numerous SG devices, generating a vast amount of SG communications traffic with various requirements. In this thesis, we assess different deployments of the SG access networks by using accurate analytical frameworks, based on queuing systems. Specifically, we develop analytical frameworks for three possible deployments considered by the energy utilities, referred to as public, private, and hybrid SG access networks. In addition, an analytical framework for a deployment of SG access networks, which is based on the concept of wireless network virtualisation, is developed. The accuracy of the derived analytical expressions is validated by simulations of a wireless network model with realistic SG traffic profiles obtained from the Australian utility operator (Ausgrid). The analytical and simulation results are shown to agree very well. Thus, these frameworks might be applied by the energy utilities and telecommunications operators as tools for designing SG access networks that satisfy their communications requirements. Finally, to meet the ever-increasing demands on the radio spectrum, arising from numerous SG devices and various applications, a novel scheduling and resource allocation algorithm is proposed for wireless SG networks.

Background: The RadiCure study examined the impact of real-time radiation monitoring on patient and operator exposure during cardiac catheterization. We sought to identify the factors associated with increased radiation exposure of the first operator. Methods: We studied the baseline clinical characteristics and procedural outcomes of 505 patients that were enrolled in the RadiCure study from January 2012 to May 2014. Multivariable analysis of high (above median or >1.0 mrem) exposure of the first operator was performed. Variables with a significant (p Results: Mean age was 65±8 years and most patients were men (99%) with a high prevalence of diabetes mellitus (54%), and prior coronary artery bypass graft surgery (30%). Median procedure time was 27 (14-51) minutes; radial access was used in 18% of cases and chronic total occlusion (CTO) interventions constituted 7% of the procedures. Median fluoroscopy time was 6.2 (2.5-12.5) minutes; median patient Air Kerma (AK) radiation exposure was 0.908 (0.602-1.636) Gray; and median first operator exposure was 1.0 (0.5-2.2) mrem. On multivariable analysis, radial access (Odds ratio [OR] 6.62, 95% Confidence Interval [CI] 3.13-14.76), followed by CTO intervention (OR 5.53, 95% CI 1.73-20.71) and patient AK radiation exposure > 0.9 Gray (OR 4.56, 95% CI 2.32-9.19) were found to be the strongest independent predictors of high first operator exposure. Real-time radiation exposure monitoring and use of a radioabsorbent drape were shown to have a significant protective effect (OR 0.33, 95% CI 0.19-0.57; and OR 0.38, 95% CI 0.18-0.77; respectively) (Figure 1). Conclusions: In the RadiCure study, high patient AK exposure, radial access and CTO intervention were associated with high first operator exposure. Real-time radiation monitoring and use of a radioabsorbent drape were independently associated with lower operator radiation exposure.

There is limited information on BTK artery variants and comparative outcome of endovascular revascularization of BTK arteries in men and women. We analyzed core laboratory adjudicated angiographic data from BTK interventions included in the Excellence in Peripheral Artery Disease (XLPAD) registry

The objective of the present study was to perform a systematic review and meta-analysis of studies reporting outcomes after first- and second-generation drug-eluting stent (DES) implantation in chronic total occlusions (CTOs).The effect of second- vs first-generation DESs on the outcomes after CTO percutaneous coronary intervention (PCI) has received limited study.As of May 2013, thirty-one published studies reported outcomes after DES implantation in CTOs: thirteen uncontrolled studies (3161 patients), three randomized (220 patients) and ten non-randomized (2150 patients) comparative studies with bare-metal stents (BMSs), and two non-randomized (685 patients) and three randomized (489 patients) comparative studies between first- and second-generation DESs. Data from the five studies comparing first with second-generation DESs were pooled using random-effects meta-analysis models.The median and mean duration of follow-up were 12 and 14.4 months, respectively. Compared to first-generation DESs, second-generation DESs were associated with lower incidence of death (odds ratio [OR], 0.37; 95% confidence intervals [CI], 0.15-0.91), target vessel revascularization (OR, 0.59; 95% CI, 0.40-0.87), binary angiographic restenosis (OR, 0.68; 95% CI, 0.46-1.01) and reocclusion (OR, 0.35; 95% CI, 0.17-0.71), but similar incidence of myocardial infarction (OR, 0.45; 95% CI, 0.10-1.95) and stent thrombosis (OR, 0.34; 95% CI, 0.07-1.59).Compared to first-generation DESs, second-generation DESs are associated with improved angiographic and clinical outcomes in CTO PCI and are the preferred stents for these challenging lesions.