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1. Percutaneous coronary intervention of chronic total occlusions involving a bifurcation: Insights from the PROGRESS-CTO registry

Author

Ilias Nikolakopoulos, Evangelia Vemmou, Judit Karacsonyi, Khaldoon Alaswad, Dimitri Karmpaliotis, Nidal Abi Rafeh, Daniel Schimmel, Keith Benzuly, James D. Flaherty, Paul Poommipanit, Ahmed M. ElGuindy, M. Nicholas Burke, and Emmanouil S. Brilakis

Subjects
chronic total occlusion, percutaneous coronary intervention, bifurcation, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background: The impact of bifurcations at the proximal or distal cap on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. Methods: We analyzed the clinical, angiographic, and procedural data of 4,584 cases performed in patients between 2012 and 2020 in a global CTO PCI registry. We compared 4 groups according to the bifurcation location: “proximal cap,” “distal cap,” “proximal and distal cap,” and “no bifurcation.” Results: The CTO involved a bifurcation in 67% cases, as follows: proximal cap (n = 1451, 33%), distal cap (n = 622, 14%), or both caps (n = 954, 21%). “Proximal and distal cap” cases had higher J-CTO compared with “proximal cap,” “distal cap,” and “no bifurcation” cases (2.9 ± 1.1 vs 2.5 ± 1.1 vs 2.4 ± 1.2 vs 2.0 ± 1.2, P

Published
2022
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2. Chronic total occlusion percutaneous coronary intervention during the COVID-19 pandemic: Insights from the PROGRESS-CTO registry

Author

Evangelia Vemmou, Khaldoon Alaswad, Jaikirshan J. Khatri, Dmitrii Khelimskii, Oleg Krestyaninov, Paul Poommipanit, Judit Karacsonyi, Ilias Nikolakopoulos, Santiago Garcia, and Emmanouil S. Brilakis

Subjects
coronary artery disease, coronary occlusion, angioplasty and stenting, percutaneous coronary intervention, COVID-19, Diseases of the circulatory (Cardiovascular) system, RC666-701
Published
2021
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3. Procedural Time and Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention

Author

Athanasios Rempakos, Spyridon Kostantinis, Bahadir Simsek, Judit Karacsonyi, James W. Choi, Paul Poommipanit, Jaikirshan J Khatri, Wissam Jaber, Stephane Rinfret, William Nicholson, Sevket Gorgulu, Farouc A. Jaffer, Raj Chandwaney, Luiz F. Ybarra, Rodrigo Bagur, Khaldoon Alaswad, Oleg Krestyaninov, Dmitrii Khelimskii, Dimitrios Karmpaliotis, Barry F. Uretsky, Korhan Soylu, Ufuk Yildirim, Srinivasa Potluri, Karim M. Al-Azizi, Bavana V. Rangan, Olga C. Mastrodemos, Salman Allana, Yader Sandoval, M. Nicholas Burke, Emmanouil S. Brilakis, and Tıp Fakültesi

Subjects
Cardiology and Cardiovascular Medicine
Abstract

Abstracat : Chronic total occlusion (CTO) percutaneous coronary interventions (PCIs) can be lengthy procedures. We sought to investigate the effect of procedural time on CTO PCI outcomes. We examined the procedural time required for the various steps of CTO PCI in 6,442 CTO PCIs at 40 US and non-US centers between 2012 and 2022. The mean and median procedure times were 129 § 76 and 112 minutes, respectively, with no significant change over time. The median times from access to wire insertion, guidewire manipulation time, and post crossing were 20, 32, and 53 minutes, respectively. Lesions crossed in

Published
2023
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4. Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention After a Previous Failed Attempt

Author

Athanasios Rempakos, Spyridon Kostantinis, Bahadir Simsek, Judit Karacsonyi, James W. Choi, Paul Poommipanit, Jaikirshan J. Khatri, Wissam Jaber, Stephane Rinfret, William Nicholson, Sevket Gorgulu, Farouc A. Jaffer, Raj Chandwaney, Luiz F. Ybarra, Rodrigo Bagur, Khaldoon Alaswad, Oleg Krestyaninov, Dmitrii Khelimskii, Dimitrios Karmpaliotis, Barry F. Uretsky, Korhan Soylu, Ufuk Yildirim, Srinivasa Potluri, Bavana V. Rangan, Olga C. Mastrodemos, Salman Allana, Yader Sandoval, Nicholas M. Burke, Emmanouil S. Brilakis, and Tıp Fakültesi

Subjects
Cardiology and Cardiovascular Medicine
Abstract

The impact of a previous failure on procedural techniques and outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. We examined the clinical and angiographic characteristics and procedural outcomes of 9,393 patients who underwent 9,560 CTO PCIs at 42 United States and non-United States centers between 2012 and 2022. A total of 1,904 CTO lesions (20%) had a previous failed PCI attempt. Patients who underwent reattempt CTO PCI were more likely to have a family history of coronary artery disease (37% vs 31%, p 30 CTO PCIs annually were more likely to achieve technical success in patients with previous failure. In conclusion, a previous failed CTO PCI attempt was associated with higher lesion complexity, longer procedure time, and lower technical success; however, the association with lower technical success did not remain significant in multivariable analysis.

Published
2023
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5. External validation of the PROGRESS-CTO perforation risk score

Author

Bahadir Simsek, Peter Tajti, Mauro Carlino, Soledad Ojeda, Manuel Pan, Stephane Rinfret, Evangelia Vemmou, Spyridon Kostantinis, Ilias Nikolakopoulos, Judit Karacsonyi, Athanasios Rempakos, Joseph A. Dens, Pierfrancesco Agostoni, Khaldoon Alaswad, Michael Megaly, Alexandre Avran, James W. Choi, Farouc A. Jaffer, Darshan Doshi, Dimitri Karmpaliotis, Jaikirshan J. Khatri, Paul Knaapen, Alessio La Manna, James C. Spratt, Masaki Tanabe, Simon Walsh, Olga C. Mastrodemos, Salman Allana, Bavana V. Rangan, Omer Goktekin, Sevket Gorgulu, Paul Poommipanit, Kathleen E. Kearney, William L. Lombardi, J. Aaron Grantham, Kambis Mashayekhi, Emmanouil S. Brilakis, Lorenzo Azzalini, Cardiology, ACS - Atherosclerosis & ischemic syndromes, and Tıp Fakültesi

Subjects
Risk Model, Percutaneous Coronary Intervention, Major Adverse Cardiovascular Events, External Validation, Radiology, Nuclear Medicine and imaging, Chronic Total Occlusion, General Medicine, Mortality, Prediction, Cardiology and Cardiovascular Medicine
Abstract

Background: Coronary artery perforation is one of the most feared and common complications of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Methods: To assess the usefulness of the recently developed PROGRESS-CTO (NCT02061436) perforation risk score in independent cohorts. Individual patient-level data pooled analysis of three registries was performed. Results: Of the 4566 patients who underwent CTO PCI at 25 centers, 196 (4.2%) had coronary artery perforation. Patients with perforations were older (69 ± 10 vs. 65 ± 10, p < 0.001), more likely to be women (19% vs. 13%, p = 0.009), more likely to have a history of prior coronary artery bypass graft (34% vs. 20%, p < 0.001), and unfavorable angiographic characteristics such as blunt stump (62% vs. 48%, p < 0.001), proximal cap ambiguity (52% vs. 34%, p < 0.001), and moderate-severe calcification (60% vs. 49%, p = 0.002). Technical success was lower in patients with perforations (73% vs. 88%, p < 0.001). The area under the receiver operating characteristic curve of the PROGRESS-CTO perforation risk model was 0.76 (95% confidence interval [CI], 0.72−0.79), with good calibration (Hosmer-Lemeshow p = 0.97). We found that the CTO PCI perforation risk increased with higher PROGRESS-CTO perforation scores: 0.3% (score 0), 2.3% (score 1), 3.1% (score 2), 5.5% (score 3), 7.5% (score 4), 14.6% (score 5). Conclusion: Given the good discriminative performance, calibration, and the ease of calculation, the PROGRESS-CTO perforation score may facilitate assessment of the risk of perforation in patients undergoing CTO PCI.

Published
2023
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6. Use of Mechanical Circulatory Support in Chronic Total Occlusion Percutaneous Coronary Intervention

Author

Judit, Karacsonyi, Karen, Deffenbacher, Keith H, Benzuly, James D, Flaherty, Khaldoon, Alaswad, Mir, Basir, Michael S, Megaly, Farouc, Jaffer, Darshan, Doshi, Paul, Poommipanit, Jaikirshan, Khatri, Mitul, Patel, Robert, Riley, Abdul, Sheikh, Jason R, Wollmuth, Ethan, Korngold, Barry F, Uretsky, Robert W, Yeh, Raj H, Chandwaney, Ahmed M, Elguindy, Khalid, Tammam, Nidal, AbiRafeh, Christian W, Schmidt, Brynn, Okeson, Spyridon, Kostantinis, Bahadir, Simsek, Bavana V, Rangan, Emmanouil S, Brilakis, and Daniel R, Schimmel

Subjects
Cardiology and Cardiovascular Medicine
Abstract

The use of mechanical circulatory support (MCS) in chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. We analyzed the clinical and angiographic characteristics, and procedural outcomes of 7,171 CTO PCIs performed between 2012 and 2021 at 35 international centers. Mean age was 64.5 ± 10 years, mean left ventricular ejection fraction was 50 ± 13%. MCS was used in 4.5%, prophylactically in 78.7%, and urgently in 21.3%. The most common type of MCS overall was Impella CP (Abiomed) (55.5%), followed by intra-aortic balloon pump (14.8%) and TandemHeart (LivaNova Inc.) (10.0%). Prophylactic MCS patients were more likely to have diabetes mellitus (55% vs 42%, p0.001) and had more complex lesions compared with cases without prophylactic MCS (Japan-CTO score: 2.80 ± 1.22 vs 2.39 ± 1.27, p0.001). Cases with prophylactic MCS had similar technical (86% vs 87%, p = 0.643) but lower procedural (80% vs 86%, p = 0.028) success rates and higher rates of periprocedural major cardiac adverse events compared with no prophylactic MCS use (6.55% vs 1.68%, p0.001). Urgent MCS use was associated with lower technical (68% vs 87%, p0.001) and procedural (39% vs 86%, p0.001) success rates and higher major cardiac adverse events compared with no-MCS use (32.26% vs 1.68%, p0.001). The differences persisted in multivariable analyses. In summary, in this contemporary multicenter registry, MCS was used in 4.5% of CTO PCIs, mostly prophylactically (78.7%). Elective MCS cases had similar technical success but a higher risk of complications. Urgent MCS cases had lower technical and procedural success and higher periprocedural major complication rates.

Published
2023
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7. Preprocedural coronary computed tomography angiography in chronic total occlusion percutaneous coronary intervention: Insights from the PROGRESS-CTO registry

Author

Bahadir Simsek, Farouc A. Jaffer, Spyridon Kostantinis, Judit Karacsonyi, Hideki Koike, Darshan Doshi, Khaldoon Alaswad, Sevket Gorgulu, Omer Goktekin, Jaikirshan Khatri, Paul Poommipanit, Oleg Krestyaninov, Rhian Davies, Ahmed ElGuindy, Brian K. Jefferson, Taral Patel, Mitul Patel, Stephane Rinfret, Wissam A. Jaber, William Nicholson, Nidal Abi Rafeh, Ufuk Yildirim, Korhan Soylu, Salman Allana, Bavana V. Rangan, Olga C. Mastrodemos, Yader Sandoval, M. Nicholas Burke, and Emmanouil S. Brilakis

Subjects
Percutaneous Coronary Intervention, Treatment Outcome, Coronary Occlusion, Computed Tomography Angiography, Risk Factors, Chronic Disease, Humans, Calcium, Registries, Coronary Angiography, Cardiology and Cardiovascular Medicine
Abstract

Preprocedural coronary computed tomography angiography (CCTA) can be useful in procedural planning for chronic total occlusion (CTO) percutaneous coronary intervention (PCI).We examined the clinical, angiographic and procedural characteristics and outcomes of cases with vs. without preprocedural CCTA in PROGRESS-CTO (NCT02061436). Multivariable logistic regression was used to adjust for confounding factors.Of 7034 CTO PCI cases, preprocedural CCTA was used in 375 (5.3%) with increasing frequency over time. Patients with preprocedural CCTA had a higher prevalence of prior coronary artery bypass graft surgery (39% vs. 27%, p 0.001) and angiographically unfavorable characteristics including higher prevalence of proximal cap ambiguity (52% vs. 33%, p 0.001) and moderate/severe calcification (59% vs. 41%, p 0.001) compared with those without CCTA. CCTA helped resolve proximal cap ambiguity in 27%, identified significant calcium not seen on diagnostic angiography in 18%, changed estimated CTO length by5 mm in 10%, and was performed as part of initial coronary artery disease work up in 19%. CCTA cases had higher J-CTO (2.6 ± 1.2 vs. 2.3 ± 1.3, p 0.001) and PROGRESS-CTO (1.3 ± 1.0 vs. 1.2 ± 1.0 p = 0.027) scores. After adjusting for potential confounders, cases with preprocedural CCTA had similar technical success (odds ratio [OR]: 1.18, 95% confidence interval [CI], 0.83-1.67) and incidence of major adverse cardiovascular events (OR: 1.47, 95% CI, 0.72-3.00).Preprocedural CCTA was used in ~5% of CTO PCI cases. While CCTA may help with procedural planning, especially in complex cases, technical success and MACE were similar with or without CCTA.

Published
2022
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8. Aortocoronary dissection during percutaneous coronary interventions for chronic total occlusion: Insights from the PROGRESS‐CTO registry

Author

Spyridon Kostantinis, Athanasios Rempakos, Bahadir Simsek, Judit Karacsonyi, Salman S. Allana, Khaldoon Alaswad, Mir Babar Basir, Oleg Krestyaninov, Dmitrii Khelimskii, Sevket Gorgulu, Rhian E. Davies, Stewart M. Benton, Jaikirshan J. Khatri, Paul Poommipanit, James W. Choi, Wissam A. Jaber, Stephane Rinfret, William Nicholson, Nazif Aygul, Bulent Behlul Altunkeser, Ahmed M. ElGuindy, Nidal Abi Rafeh, Omer Goktekin, Olga C. Mastrodemos, Bavana V. Rangan, Yader Sandoval, M. Nicholas Burke, and Emmanouil S. Brilakis

Subjects
Radiology, Nuclear Medicine and imaging, General Medicine, Cardiology and Cardiovascular Medicine
Published
2023
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9. Angiographic Features and Clinical Outcomes of Balloon Uncrossable Lesions during Chronic Total Occlusion Percutaneous Coronary Intervention

Author

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

Subjects
balloon uncrossable, Heart Disease, Percutaneous Coronary Intervention, Balloon Uncrossable, percutaneous coronary intervention, Medicine (miscellaneous), chronic total occlusion, 03.02. Klinikai orvostan, Chronic Total Occlusion, Atherosclerosis, Cardiovascular, Heart Disease - Coronary Heart Disease
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
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10. Development of a Novel Score to Predict Urgent Mechanical Circulatory Support in Chronic Total Occlusion Percutaneous Coronary Intervention

Author

Judit Karacsonyi, Larissa Stanberry, Bahadir Simsek, Spyridon Kostantinis, Salman S. Allana, Athanasios Rempakos, Brynn Okeson, Khaldoon Alaswad, Mir B. Basir, Farouc Jaffer, Paul Poommipanit, Jaikirshan Khatri, Mitul Patel, Ehtisham Mahmud, Abdul Sheikh, Jason R. Wollmuth, Robert W Yeh, Raj H. Chandwaney, Ahmed M ElGuindy, Nidal AbiRafeh, Daniel R. Schimmel, Keith Benzuly, M. Nicholas Burke, Bavana V. Rangan, Olga C. Mastrodemos, Yader Sandoval, Imre Ungi, and Emmanouil S. Brilakis

Abstract

BackgroundEstimating the likelihood of urgent mechanical circulatory support (MCS) can facilitate procedural planning and clinical decision making in chronic total occlusion (CTO) percutaneous coronary intervention (PCI).MethodsWe analyzed 2,784 CTO PCIs performed between 2012 and 2021 at 12 centers. The variable importance was estimated by a bootstrap applying a random forest algorithm to a propensity-matched sample (a ratio of 1:5 matching cases with controls on center). The identified variables were used to predict the risk of urgent MCS. The performance of the risk model was assessed in-sample as well as on 2411 out-of-sample procedures who did not require urgent MCS.ResultsUrgent MCS was used in 62 (2.2%) of cases. Patients who required urgent MCS were older (70 [63, 77] vs. 66 [58, 73] years, p=0.003) compared with those who did not require urgent MCS. Technical (68% vs. 87%, pConclusionThe PROGRESS CTO MCS score can help estimate the risk of urgent MCS use during CTO PCI.What Is Known?Estimating the likelihood of urgent mechanical circulatory support (MCS) can facilitate procedural planning and clinical decision making in chronic total occlusion (CTO) percutaneous coronary intervention (PCI).What the Study Adds?We developed a risk model for urgent MCS use during CTO PCI using retrograde crossing strategy, left ventricular ejection fraction, and lesion length.Use of the PROGRESS CTO urgent MCS score may facilitate patient selection for prophylactic hemodynamic support optimizing the risk benefit ratio of the procedure.

Published
2023
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11. Impact of lesion length on the outcomes of chronic total occlusion percutaneous coronary intervention: Insights from the PROGRESS‐CTO registry

Author

Athanasios Rempakos, Bahadir Simsek, Spyridon Kostantinis, Judit Karacsonyi, James W. Choi, Paul Poommipanit, Jaikirshan J. Khatri, Wissam Jaber, Stephane Rinfret, William Nicholson, Sevket Gorgulu, Farouc A. Jaffer, Raj Chandwaney, Michael Koutouzis, Ioannis Tsiafoutis, Khaldoon Alaswad, Oleg Krestyaninov, Dmitrii Khelimskii, Dimitrios Karmpaliotis, Barry F. Uretsky, Mitul P. Patel, Ehtisham Mahmud, Srinivasa Potluri, Bavana V. Rangan, Olga C. Mastrodemos, Salman Allana, Yader Sandoval, Nicholas M. Burke, Emmanouil S. Brilakis, and Tıp Fakültesi

Subjects
Lesion Length, Occlusion Length, Percutaneous Coronary Intervention, Radiology, Nuclear Medicine and imaging, General Medicine, Chronic Total Occlusion, Cardiology and Cardiovascular Medicine
Abstract

Background: The impact of occlusion length on the procedural techniques and outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. Methods: We examined the clinical and angiographic characteristics and procedural outcomes of 10,335 CTO PCIs at 42 US and non-US centers between 2012 and 2022. The cohort was divided into two groups based on lesion length (≥20 mm vs.

Published
2023

12. Impact of proximal cap ambiguity on the procedural techniques and outcomes of chronic total occlusion percutaneous coronary intervention: Insights from the PROGRESS‐CTO Registry

Author

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

Subjects
Percutaneous Coronary Intervention, Radiology, Nuclear Medicine and imaging, General Medicine, Chronic Total Occlusion, Proximal Cap Ambiguity, Cardiology and Cardiovascular Medicine
Abstract

Background: Proximal cap ambiguity is a key parameter in the global chronic total occlusion (CTO) percutaneous coronary intervention (PCI) crossing algorithm. Methods: We examined the baseline characteristics and procedural outcomes of 9718 CTO PCIs performed in 9498 patients at 41 US and non-US centers between 2012 and 2022. Results: Proximal cap ambiguity was present in 35% of CTO lesions. Patients whose lesions had proximal cap ambiguity were more likely to have had prior coronary artery bypass graft surgery (37% vs. 24%; p < 0.001). Lesions with proximal cap ambiguity were more complex with higher J-CTO score (3.1 ± 1.0 vs. 2.0 ± 1.2; p < 0.001) and lower technical (79% vs. 90%; p < 0.001) and procedural (77% vs. 89%; p < 0.001) success rates compared with nonambiguous CTO lesions. The incidence of major adverse cardiovascular events (MACE) was higher in cases with proximal cap ambiguity (2.5% vs. 1.7%; p < 0.001). The retrograde approach was more commonly used among cases with ambiguous proximal cap (50% vs. 21%; p < 0.001) and was more likely to be the final successful crossing strategy (29% vs. 13%; p < 0.001). The antegrade dissection and re-entry (ADR) "move-the-cap" techniques were also more common among cases with proximal cap ambiguity. Conclusions: Proximal cap ambiguity in CTO lesions is associated with higher utilization of the retrograde approach and ADR, lower technical and procedural success rates, and higher incidence of in-hospital MACE.

Published
2023

13. Cardiogenic shock secondary to stress-induced cardiomyopathy precipitated by severe diabetic ketoacidosis

Author

Riley Gurreri, Paul Poommipanit, and Abdullah Alghamdi

Subjects
Infectious Diseases, Parasitology, Microbiology
Abstract

Stress-induced cardiomyopathy is caused by neurohormonal release of catecholamines. Although diabetic ketoacidosis (DKA) is a well-known complication of diabetes, diabetes mellitus is usually protective of stress-induced cardiomyopathy. Stress-induced cardiomyopathy secondary to DKA is extremely rare; however, cardiogenic shock is a potential complication of stress-induced cardiomyopathy. We present a rare case describing diabetic ketoacidosis leading to profound acidosis causing stress-induced cardiomyopathy and cardiogenic shock that is successfully managed with venoarterial extracorporeal membrane oxygenation in adults.

Published
2023
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14. List of contributors

Author

Nidal Abi Rafeh, Pierfrancesco Agostoni, Sukru Akyuz, Khaldoon Alaswad, Ziad A. Ali, Salman S. Allana, Chadi Alraies, Mario Araya, Alexandre Avran, Lorenzo Azzalini, Avtandil Babunashvili, Subhash Banerjee, Sripal Bangalore, Baktash Bayani, Michael Behnes, Ravinay Bhindi, Nicolas Boudou, Nenad Ž. Božinović, Leszek Bryniarski, Alexander Bufe, Christopher E. Buller, M. Nicholas Burke, Pedro Pinto Cardoso, Mauro Carlino, Joao L. Cavalcante, Tarek Chami, Raj H. Chandwaney, Konstantinos Charitakis, Victor Y. Cheng, James W. Choi, Evald Høj Christiansen, Yashasvi Chugh, Antonio Colombo, Claudia Cosgrove, Kevin Croce, Ramesh Daggubati, Félix Damas de los Santos, Rustem Dautov, Rhian E. Davies, Tony de Martini, Ali E. Denktas, Joseph Dens, Carlo di Mario, Roberto Diletti, Zisis Dimitriadis, Darshan Doshi, Parag Doshi, Kefei Dou, Mohaned Egred, Basem Elbarouni, Ahmed M. ElGuindy, Amr Elhadidy, Stephen Ellis, Javier Escaned, Panayotis Fasseas, Farshad Forouzandeh, Sergey Furkalo, Andrea Gagnor, Alfredo R. Galassi, Robert Gallino, Roberto Garbo, Santiago Garcia, Gabriele Gasparini, Junbo Ge, Lei Ge, Pravin Kumar Goel, Omer Goktekin, Nieves Gonzalo, Sevket Gorgulu, Luca Grancini, J. Aaron Grantham, Raviteja Guddeti, Elias V. Haddad, Allison B. Hall, Jack J. Hall, Sean Halligan, Franklin Leonardo Hanna Quesada, Colm Hanratty, Stefan Harb, Scott A. Harding, Raja Hatem, David Hildick-Smith, Jonathan M. Hill, Taishi Hirai, Mario Iannaccone, Wissam Jaber, Farouc A. Jaffer, Yangsoo Jang, Brian K. Jefferson, Allen Jeremias, Risto Jussila, Nikolaos Kakouros, Artis Kalnins, Sanjog Kalra, Arun Kalyanasundaram, David E. Kandzari, Hsien-Li Kao, Judit Karacsonyi, Dimitri Karmpaliotis, Hussien Heshmat Kassem, Kathleen Kearney, Jimmy Kerrigan, Jaikirshan Khatri, Dmitrii Khelimskii, Ajay J. Kirtane, Paul Knaapen, Spyridon Kostantinis, Michalis Koutouzis, Mihajlo Kovacic, Oleg Krestyaninov, A.V. Ganesh Kumar, Prathap Kumar N., Katherine J. Kunkel, Pablo Manuel Lamelas, Seung-Whan Lee, Thierry Lefevre, Gregor Leibundgut, Nicholas J. Lembo, Martin Leon, John R. Lesser, Raymond Leung, Soo-Teik Lim, Sidney Tsz Ho Lo, William Lombardi, Michael Luna, Ehtisham Mahmud, Madeline K. Mahowald, Anbukarasi Maran, Konstantinos Marmagkiolis, Evandro Martins Filho, Kambis Mashayekhi, Margaret B. McEntegart, Michael Megaly, Perwaiz Meraj, Lampros Michalis, Anastasios N. Milkas, Owen Mogabgab, Jeffrey Moses, Muhammad Munawar, Bilal Murad, Alexander Nap, Andres Navarro, William J. Nicholson, Anja Øksnes, Göran Olivecrona, Mohamed A. Omer, Jacopo Andrea Oreglia, Lucio Padilla, Mitul P. Patel, Rajan A.G. Patel, Taral Patel, Ashish Pershad, Duane Pinto, Paul Poommipanit, Marin Postu, Srini Potluri, Stylianos Pyxaras, Alexandre Schaan de Quadros, Michael Ragosta, Sunil V. Rao, Vithala Surya Prakasa Rao, Sudhir Rathore, Joerg Reifart, Athanasios Rempakos, Jeremy Rier, Robert Riley, Stéphane Rinfret, Juan J. Russo, Meruzhan Saghatelyan, Gurpreet S. Sandhu, Yader Sandoval, Ricardo Santiago, James Sapontis, Alpesh Shah, Evan Shlofmitz, Kendrick A. Shunk, George Sianos, Bahadir Simsek, Elliot J. Smith, Anthony Spaedy, James Spratt, Julian W. Strange, Bradley Strauss, Péter Tajti, Hector Tamez, Khalid O. Tammam, Craig A. Thompson, Aurel Toma, Catalin Toma, Ioannis Tsiafoutis, Etsuo Tsuchikane, Imre Ungi, Barry F. Uretsky, Georgios J. Vlachojannis, Minh Nhat Vo, Hoang Vu Vu, Simon Walsh, Daniel Weilenmann, Gerald Werner, Jarosław Wójcik, Jason Wollmuth, Eugene B. Wu, R. Michael Wyman, Iosif Xenogiannis, Bo Xu, Masahisa Yamane, Luiz F. Ybarra, and Robert W. Yeh

Published
2023
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15. Outcomes of Patients With Acute Coronary Syndromes Undergoing Chronic Total Occlusion Percutaneous Coronary Intervention

Author

Bahadir, Simsek, Spyridon, Kostantinis, Judit, Karacsonyi, Sevket, Gorgulu, Khaldoon, Alaswad, Farouc A, Jaffer, Darshan, Doshi, Jaikirshan, Khatri, Paul, Poommipanit, Nazif, Aygul, Nidal, Abi Rafeh, Oleg, Krestyaninov, Dmitrii, Khelimskii, Barry, Uretsky, Rhian, Davies, Omer, Goktekin, Ahmed, ElGuindy, Brian K, Jefferson, Taral N, Patel, Mitul, Patel, Olga C, Mastrodemos, Bavana V, Rangan, Salman, Allana, Yader, Sandoval, M Nicholas, Burke, and Emmanouil S, Brilakis

Subjects
Percutaneous Coronary Intervention, Treatment Outcome, Coronary Occlusion, Risk Factors, Chronic Disease, Humans, ST Elevation Myocardial Infarction, Stroke Volume, Prospective Studies, Registries, Acute Coronary Syndrome, Coronary Angiography, Ventricular Function, Left
Abstract

The prevalence and outcomes of patients who presented with an acute coronary syndrome (ACS) and underwent chronic total occlusion (CTO) percutaneous coronary intervention (PCI) have received limited study.We examined the clinical characteristics and procedural outcomes of ACS patients who underwent CTO-PCI in the Prospective Global Registry for the Study of CTO Intervention (PROGRESS-CTO; NCT02061436).Of the 8826 patients who underwent CTO-PCI between 2012 and 2022 at 38 centers, 558 (6.3%) presented with ACS. ACS presentation was with non-ST-segment elevation myocardial infarction (MI) in 54%, unstable angina in 33%, and ST-segment elevation MI in 6.5%. ACS patients were older (66 ± 11 years vs 64 ± 10 years; P.001) and had higher prevalence of comorbidities such as diabetes mellitus (48% vs 42%; P=.02), prior MI (52% vs 45%; P.01), and lower left ventricular ejection fraction (49 ± 14% vs 51 ± 13%; P.01). While the PROGRESS-CTO score (1.4 ± 1.0 vs 1.2 ± 1.0; P.001) was higher in the ACS group, the J-CTO score was comparable (2.3 ± 1.2 vs 2.4 ± 1.3; P=.68). Technical success (88% vs 86%; P=.12) and the incidence of in-hospital major adverse cardiovascular event (MACE) (0.9% vs 2.1%; P=.06) and adverse events at 3-month follow-up (3.4% vs 7.2%; Kaplan-Meier log-rank P=.16) were similar between ACS and non-ACS patients, respectively.Approximately 6% of patients who underwent CTO-PCI presented with an ACS. Technical success, in-hospital MACE, and the incidence of adverse events up to 3 months were similar between patients who presented with vs without an ACS.

Published
2022

16. Saphenous Vein Graft Occlusion Following Native Vessel Chronic Total Occlusion Percutaneous Coronary Intervention

Author

Spyridon, Kostantinis, Bahadir, Simsek, Judit, Karacsonyi, Khaldoon, Alaswad, Michael, Megaly, Farouc A, Jaffer, Jaikirshan J, Khatri, Paul, Poommipanit, Rhian E, Davies, Stephane, Rinfret, Basem, Elbarouni, Luiz F, Ybarra, Abdul M, Sheikh, Catalin, Toma, Raj, Chandwaney, Nidal, Abi Rafeh, Omer, Goktekin, Ahmed M, El Guindy, Salman, Allana, Olga C, Mastrodemos, Bavana V, Rangan, Yader, Sandoval, M Nicholas, Burke, and Emmanouil S, Brilakis

Abstract

Whether saphenous vein grafts (SVGs) should be occluded after successful chronic total occlusion (CTO) percutaneous coronary intervention (PCI) of the corresponding native vessel remains controversial.We analyzed the clinical and angiographic characteristics and procedural outcomes of 51 patients who underwent SVG occlusion following successful CTO-PCI of the corresponding native vessel between 2015 and 2022 at 14 centers.Mean patient age was 71 ± 8 years and 80% were men. The most common CTO target vessel was the right coronary artery (41%), followed by the left circumflex (37%). Retrograde crossing through the SVG was the successful crossing strategy in 40 cases (78%). SVG occlusion was achieved with coils (1.9 ± 1.0) in 35 of 51 patients (69%) and vascular plugs in the other 16 cases (31%). All procedures were technically successful and the SVG was occluded completely (TIMI 0 flow) in 38 of the cases (75%), with the remaining cases having TIMI 1 flow. Follow-up was available for 37 patients (73%); during a mean follow-up of 312 days from CTO-PCI, the incidence of target-lesion failure due to restenosis was 5.4% (n = 2) with no other major events reported.Following native vessel CTO-PCI, SVG occlusion is often performed and is associated with favorable mid-term outcomes.

Published
2022

17. Laser for balloon uncrossable and undilatable chronic total occlusion interventions

Author

Nidal Abi Rafeh, Khaldoon Alaswad, Mohaned Egred, Emmanouil S. Brilakis, James W. Choi, Evangelia Vemmou, Imre Ungi, Ahmed ElGuindy, Judit Karacsonyi, Ilias Nikolakopoulos, and Paul Poommipanit

Subjects
Male, medicine.medical_specialty, Percutaneous, medicine.medical_treatment, Psychological intervention, 030204 cardiovascular system & hematology, Coronary Angiography, Balloon, Total occlusion, 03 medical and health sciences, Percutaneous Coronary Intervention, 0302 clinical medicine, Risk Factors, Patient age, medicine, Humans, Registries, 030212 general & internal medicine, Major complication, Aged, business.industry, Lasers, Percutaneous coronary intervention, Middle Aged, Surgery, Treatment Outcome, Coronary Occlusion, Chronic Disease, Conventional PCI, Cardiology and Cardiovascular Medicine, business
Abstract

There is limited information on use of laser in complex percutaneous coronary interventions (PCI). We examined the impact of laser on the outcomes of balloon uncrossable and balloon undilatable chronic total occlusion (CTO) PCI.We reviewed baseline clinical and angiographic characteristics and procedural outcomes of 4845 CTO PCIs performed between 2012 and 2020 at 32 centers.Of the 4845 CTO lesions, 752 (15.5%) were balloon uncrossable (523 cases) or balloon undilatable (356 cases) and were included in this analysis. Mean patient age was 66.9 ± 10 years and 83% were men. Laser was used in 20.3% of the lesions. Compared with cases in which laser was not used, laser was more commonly used in longer length occlusions (33 [21, 50] vs. 25 [15, 40] mm, p = 0.0004) and in-stent restenotic lesions (41% vs. 20%, p0.0001). Laser use was associated with higher technical (91.5% vs. 83.1%, p = 0.010) and procedural (88.9% vs. 81.6%, p = 0.033) success rates and similar incidence of major adverse cardiac events (3.92% vs. 3.51%, p = 0.805). Laser use was associated with longer procedural (169 [109, 231] vs. 130 [87, 199], p0.0001) and fluoroscopy time (64 [40, 94] vs. 50 [31, 81], p = 0.003).In a contemporary, multicenter registry balloon uncrossable and balloon undilatable lesions represented 15.5% of all CTO PCIs. Laser was used in approximately one-fifth of these cases and was associated with high technical and procedural success and similar major complication rates.

Published
2021
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18. B-11 | Donor Vessel Injury During Percutaneous Coronary Interventions for Chronic Total Occlusion: Insights from the PROGRESS-CTO registry

Author

Spyridon Kostantinis, Athanasios Rempakos, Bahadir Simsek, Judit Karacsonyi, Salman S. Allana, Khaldoon Alaswad, Mir B. Basir, Oleg Krestyaninov, Dmitrii Khelimskii, Şevket Görgülü, Rhian E. Davies, Stewart M. Benton, Jaikirshan Khatri, Paul Poommipanit, James W. Choi, Wissam A. Jaber, Stéphane Rinfret, William J. Nicholson, Nazif Aygul, Bulent Behlul Altunkeser, Michail Koutouzis, Ioannis Tsiafoutis, Ahmed Elguindy, Nidal Abi Rafeh, Ömer Göktekin, Olga C. Mastrodemos, Bavana V. Rangan, Yader B. Sandoval, M. Nicholas Burke, and Emmanouil S. Brilakis

Published
2023
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19. B-20 | Assessment of the ERCTO Score for Predicting Success in Retrograde Chronic Total Occlusion Percutaneous Coronary Interventions in the PROGRESS-CTO Registry

Author

Athanasios Rempakos, Bahadir Simsek, Spyridon Kostantinis, Judit Karacsonyi, James W. Choi, Paul Poommipanit, Jaikirshan Khatri, Wissam A. Jaber, Stéphane Rinfret, William J. Nicholson, Şevket Görgülü, Farouc A. Jaffer, Brian Jefferson, Khaldoon Alaswad, Oleg Krestyaninov, Dmitrii Khelimskii, Dimitrios Karmpaliotis, Rhian E. Davies, Stewart M. Benton, Nazif Aygul, Srini Potluri, Karim Al-Azizi, Bavana V. Rangan, Olga Mastrodemos, Salman S. Allana, Yader B. Sandoval, M. Nicholas Burke, and Emmanouil S. Brilakis

Published
2023
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20. B-12 | Approaches to and Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention of the Left Anterior Descending Artery: Insights from the PROGRESS-CTO Registry

Author

Spyridon Kostantinis, Athanasios Rempakos, Bahadir Simsek, Judit Karacsonyi, Salman S. Allana, Khaldoon Alaswad, Mir B. Basir, Oleg Krestyaninov, Dmitrii Khelimskii, Şevket Görgülü, Rhian E. Davies, Farouc A. Jaffer, Jaikirshan Khatri, Paul Poommipanit, James W. Choi, Wissam A. Jaber, Stéphane Rinfret, William J. Nicholson, Brian Jefferson, Taral N. Patel, Karim Al-Azizi, Srini Potluri, Basem Elbarouni, Nazif Aygul, Bulent Behlul Altunkeser, Ahmed Elguindy, Nidal Abi Rafeh, Ömer Göktekin, Olga Mastrodemos, Bavana V. Rangan, Yader B. Sandoval, M. Nicholas Burke, and Emmanouil S. Brilakis

Published
2023
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21. B-19 | Follow-Up Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention: Insights from the PROGRESS-CTO Registry

Author

Athanasios Rempakos, Spyridon Kostantinis, Bahadir Simsek, Judit Karacsonyi, James W. Choi, Paul Poommipanit, Jaikirshan Khatri, Wissam A. Jaber, Stéphane Rinfret, William J. Nicholson, Şevket Görgülü, Farouc A. Jaffer, Brian Jefferson, Khaldoon Alaswad, Oleg Krestyaninov, Dmitrii Khelimskii, Dimitrios Karmpaliotis, Rhian E. Davies, Stewart M. Benton, Nazif Aygul, Jarrod Frizzell, M. Niranjan Reddy, Bavana V. Rangan, Olga Mastrodemos, Salman S. Allana, Yader B. Sandoval, M. Nicholas Burke, and Emmanouil S. Brilakis

Published
2023
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22. B-18 | Procedural Time and Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention: Insights from the PROGRESS-CTO Registry

Author

Athanasios Rempakos, Spyridon Kostantinis, Bahadir Simsek, Judit Karacsonyi, James W. Choi, Paul Poommipanit, Jaikirshan Khatri, Wissam A. Jaber, Stéphane Rinfret, William J. Nicholson, Şevket Görgülü, Farouc A. Jaffer, Raj H. Chandwaney, Luiz Fernando Ybarra, Rodrigo Bagur, Khaldoon Alaswad, Oleg Krestyaninov, Dmitrii Khelimskii, Dimitrios Karmpaliotis, Barry F. Uretsky, Korhan Soylu, Ufuk Yildirim, Srini Potluri, Karim Al-Azizi, Bavana V. Rangan, Olga Mastrodemos, Salman S. Allana, Yader B. Sandoval, M. Nicholas Burke, and Emmanouil S. Brilakis

Published
2023
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23. B-24 | Periprocedural Mortality in Chronic Total Occlusion Percutaneous Coronary Intervention: Insights from the PROGRESS-CTO Registry

Author

Bahadir Simsek, Athanasios Rempakos, Spyridon Kostantinis, Judit Karacsonyi, Şevket Görgülü, Khaldoon Alaswad, James W. Choi, Farouc A. Jaffer, Darshan Doshi, Paul Poommipanit, Nazif Aygul, Oleg Krestyaninov, Dmitrii Khelimskii, Barry F. Uretsky, Rhian E. Davies, Ömer Göktekin, Ahmed Elguindy, Brian Jefferson, Taral N. Patel, Mitul P. Patel, Abdul M. Sheikh, Dimitrios Karmpaliotis, Srini Potluri, Karim Al-Azizi, Olga C. Mastrodemos, Bavana V. Rangan, Salman S. Allana, Yader B. Sandoval, M. Nicholas Burke, and Emmanouil S. Brilakis

Published
2023
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24. B-13 | Impact of Proximal Vessel Tortuosity on Procedural Techniques and Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention: Insights from the PROGRESS-CTO Registry

Author

Spyridon Kostantinis, Athanasios Rempakos, Bahadir Simsek, Judit Karacsonyi, Salman S. Allana, Khaldoon Alaswad, Mir B. Basir, Oleg Krestyaninov, Dmitrii Khelimskii, Şevket Görgülü, Rhian E. Davies, Stewart M. Benton, Jaikirshan Khatri, Paul Poommipanit, James W. Choi, Wissam A. Jaber, Stéphane Rinfret, William J. Nicholson, Farouc A. Jaffer, Dr. Jimmy Lee Kerrigan, Elias Victor Haddad, Mitul P. Patel, Ehtisham Mahmud, Korhan Soylu, Ufuk Yildirim, Ahmed Elguindy, Nidal Abi Rafeh, Ömer Göktekin, Olga Mastrodemos, Bavana V. Rangan, Yader B. Sandoval, M. Nicholas Burke, and Emmanouil S. Brilakis

Published
2023
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25. Predictors of success in primary retrograde strategy in chronic total occlusion percutaneous coronary intervention: insights from the PROGRESS-chronic total occlusion registry

Author

Bahadir Simsek, Spyridon Kostantinis, Judit Karacsonyi, Khaldoon Alaswad, Dimitri Karmpaliotis, Amirali Masoumi, Farouc A. Jaffer, Darshan Doshi, Jaikirshan Khatri, Paul Poommipanit, Sevket Gorgulu, Nidal Abi Rafeh, Omer Goktekin, Oleg Krestyaninov, Rhian Davies, Ahmed ElGuindy, Elias V. Haddad, Jimmy Kerrigan, Mitul Patel, Raj H. Chandwaney, Olga C. Mastrodemos, Salman Allana, Bavana V. Rangan, and Emmanouil S. Brilakis

Subjects
Male, General Medicine, Middle Aged, Coronary Angiography, Percutaneous Coronary Intervention, Treatment Outcome, Coronary Occlusion, Risk Factors, Chronic Disease, Humans, Radiology, Nuclear Medicine and imaging, Female, Prospective Studies, Registries, Cardiology and Cardiovascular Medicine, Aged
Abstract

An upfront (primary) retrograde strategy is often used in complex chronic total occlusion (CTO) percutaneous coronary intervention (PCI).We examined the clinical, angiographic characteristics, and procedural outcomes of CTO PCIs that were approached with a primary retrograde strategy in the Prospective Global Registry for the Study of CTO Intervention (PROGRESS-CTO, NCT02061436).Of 10,286 CTO PCIs performed between 2012 and 2022, a primary retrograde strategy was used in 1329 (13%) with an initial technical success of 66%, and a final success of 83%. Patients who underwent successful versus unsuccessful primary retrograde cases had similar characteristics: age (65 ± 10 vs. 65 ± 9, years, p = 0.203), men (83% vs. 87%, p = 0.066), prior PCI (71% vs. 71%, p = 0.809), and prior coronary artery bypass graft surgery (52% vs. 53%, p = 0.682). The PROGRESS-CTO score (1.3 ± 0.9 vs. 1.6 ± 0.9, p 0.001), air kerma radiation (3.9 ± 2.8 vs. 3.4 ± 2.6, gray, p = 0.013), and contrast use (294 ± 148 ml vs. 248 ± 128, ml, p 0.001) were higher in the unsuccessful group, whereas the presence of interventional collaterals (95% vs. 72%, p 0.001) and Werner collateral connection grade 2 (43% vs. 31%, p 0.001) were higher in the successful group. On multivariable logistic regression analysis, the only variable associated with a successful primary retrograde strategy was the presence of interventional collaterals: odds ratio: 6.52 (95% confidence intervals; 3.5-12.1, p 0.001).Presence of interventional collaterals is independently associated with higher success rates with a primary retrograde strategy in CTO PCI.

Published
2022

26. Prevalence and outcomes of balloon undilatable chronic total occlusions: Insights from the PROGRESS-CTO

Author

Bahadir Simsek, Spyridon Kostantinis, Judit Karacsonyi, Khaldoon Alaswad, Dimitri Karmpaliotis, Amirali Masoumi, Farouc A. Jaffer, Darshan Doshi, Jaikirshan Khatri, Paul Poommipanit, Sevket Gorgulu, Nidal Abi Rafeh, Omer Goktekin, Oleg Krestyaninov, Rhian Davies, Ahmed ElGuindy, Brian K. Jefferson, Taral N. Patel, Mitul Patel, Raj H. Chandwaney, Olga C. Mastrodemos, Bavana V. Rangan, and Emmanouil S. Brilakis

Subjects
Percutaneous Coronary Intervention, Treatment Outcome, Coronary Occlusion, Risk Factors, Chronic Disease, Prevalence, Humans, Hospital Mortality, Prospective Studies, Registries, Middle Aged, Cardiology and Cardiovascular Medicine, Aged
Abstract

The prevalence, treatment, and outcomes of balloon undilatable lesions encountered in chronic total occlusion (CTO) percutaneous coronary intervention (PCI) have received limited study.We examined the clinical characteristics and procedural outcomes of balloon undilatable lesions in the Prospective Global Registry for the Study of CTO Intervention (PROGRESS-CTO, NCT02061436).Of 6535 CTO PCIs performed between 2012 and 2022, 558 (8.5%) lesions were balloon undilatable. In this subset, patients were older (mean age 67 ± 10 vs. 64 ± 10, p 0.001) and had higher prevalence of comorbidities: diabetes mellitus (54% vs. 40%, p 0.001), prior PCI (71% vs. 59%, p 0.001), prior myocardial infarction (52% vs. 45%, p = 0.003), and prior coronary artery bypass graft surgery (44% vs. 25%, p 0.001). The CTO lesion length was estimated to be 34 ± 23 mm, mean J-CTO score was 2.9 ± 1.1 and mean PROGRESS-CTO score was 1.4 ± 1.0. A cutting balloon was used in 27%, a scoring balloon in 15%, laser in 14%, rotational atherectomy in 28%, orbital atherectomy in 10%, intravascular lithotripsy in 1% and other modalities/approaches in 5%. Balloon undilatable lesions had lower technical success (90.9% vs. 93.8%, p = 0.007) and higher incidence of major adverse cardiovascular events (MACE) (composite of in-hospital death, acute myocardial infarction, stroke, re-PCI, emergency CABG, and pericardiocentesis) (5.0% versus 1.3%, p 0.001).Approximately 1 in 12 CTO (8.5%) lesions are balloon undilatable. Treatment of balloon undilatable lesions is associated with lower technical success and higher in-hospital MACE.

Published
2022

27. Outcomes of chronic total occlusion percutaneous coronary intervention in patients with reduced left ventricular ejection fraction

Author

Bahadir Simsek, Spyridon Kostantinis, Judit Karacsonyi, Khaldoon Alaswad, Dimitri Karmpaliotis, Amirali Masoumi, Farouc A. Jaffer, Darshan Doshi, Jaikirshan Khatri, Paul Poommipanit, Sevket Gorgulu, Omer Goktekin, Oleg Krestyaninov, Rhian Davies, Ahmed ElGuindy, Brian K. Jefferson, Taral N. Patel, Mitul Patel, Raj H. Chandwaney, Kambis Mashayekhi, Alfredo R. Galassi, Bavana V. Rangan, Emmanouil S. Brilakis, Simsek B., Kostantinis S., Karacsonyi J., Alaswad K., Karmpaliotis D., Masoumi A., Jaffer F.A., Doshi D., Khatri J., Poommipanit P., Gorgulu S., Goktekin O., Krestyaninov O., Davies R., ElGuindy A., Jefferson B.K., Patel T.N., Patel M., Chandwaney R.H., Mashayekhi K., Galassi A.R., Rangan B.V., and Brilakis E.S.

Subjects
Male, clinical outcome, Aftercare, left ventricular ejection fraction, Stroke Volume, General Medicine, Middle Aged, Coronary Angiography, Patient Discharge, Ventricular Function, Left, Percutaneous Coronary Intervention, Treatment Outcome, Coronary Occlusion, Risk Factors, Chronic Disease, Humans, Radiology, Nuclear Medicine and imaging, Female, Prospective Studies, Cardiology and Cardiovascular Medicine, chronic total occlusion, Aged
Abstract

Background: The relationship between left ventricular ejection fraction (LVEF) and the success and safety of coronary chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. Methods: We examined the clinical characteristics and outcomes of CTO PCI in the Prospective Global Registry for the Study of CTO Intervention (PROGRESS-CTO) after stratifying patients by LVEF (≤35%, 36%–49%, and ≥50%). Results: A total of 7827 CTO PCI procedures with LVEF data were included. Mean age was 64 ± 10 years, 81% were men, 43% had diabetes mellitus, 61% had prior PCI, 45% had prior myocardial infarction, and 29% had prior coronary artery bypass graft surgery. Technical success was similar in the three LVEF strata: 85%, 86%, and 87%, p = 0.391 for LVEF ≤35%, 36%–49%, and ≥50%, respectively. In-hospital mortality was higher in lower LVEF patients (1.1%, 0.4%, and 0.3%, respectively, p = 0.001). In-hospital major adverse cardiovascular events (MACE) were numerically higher in lower EF patients (2.7%, 2.1%, and 1.9%, p = 0.271). At a median follow-up of 2 months (interquartile range: 19-350 days), patients with lower LVEF continued to have higher mortality (4.9%, 3.2%, and 1.4%, p < 0.001) while the MACE rates were similar (9.3%, 9.6%, and 7.4%, p = 0.172). Conclusion: CTO PCI can be performed with high technical success in patients with reduced LVEF but is associated with higher in-hospital and post-discharge mortality.

Published
2022

28. Use of the Limited Antegrade Subintimal Tracking Technique in Chronic Total Occlusion Percutaneous Coronary Intervention

Author

Judit Karacsonyi, Spyridon Kostantinis, Bahadir Simsek, Khaldoon Alaswad, Dimitri Karmpaliotis, Ajay Kirtane, Farouc Jaffer, James W. Choi, Michalis Koutouzis, Ioannis Tsiafoutis, David E. Kandzari, Paul Poommipanit, Jaikirshan J. Khatri, Basem Elbarouni, Sevket Gorgulu, Ahmed ElGuindy, Nidal Abi Rafeh, Omer Goktekin, Imre Ungi, Bavana V. Rangan, Yader Sandoval, Salman Allana, M. Nicholas Burke, Emmanouil S. Brilakis, and Tıp Fakültesi

Subjects
Male, Chronic Total Occlusion, Middle Aged, Percutaneous Coronary Intervention, Treatment Outcome, Coronary Occlusion, Humans, Female, Prospective Studies, Registries, 03.02. Klinikai orvostan, Cardiology and Cardiovascular Medicine, Limited Antegrade Subintimal Tracking, Aged
Abstract

BACKGROUND There are limited data on the limited antegrade subintimal tracking (LAST) technique for chronic total occlusion (CTO) percutaneous coronary intervention (PCI).OBJECTIVES The aim of this study was to analyze the frequency of use and outcomes of the LAST technique for CTO PCI.METHODS We analyzed 2,177 CTO PCIs performed using antegrade dissection and re-entry (ADR) in the PROGRESS-CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) registry between 2012 and January 2022 at 39 centers. ADR was attempted in 1,465 cases (67.3%).RESULTS Among antegrade re-entry cases, LAST was used in 163 (11.1%) (primary LAST in 127 [8.7%] and secondary LAST [LAST after other ADR approaches failed] in 36 [2.5%]), the Stingray system (Boston Scientific) in 980 (66.9%), subintimal tracking and re-entry in 387 (26.4%), and contrast-guided subintimal tracking and re-entry in 29 (2.0%). The mean patient age was 65.2 similar to 10 years, and 85.8% were men. There was no significant difference in technical (71.8% vs 77.8%; P 1/4 0.080) and procedural (69.9% vs 75.3%; P 1/4 0.127) success and major cardiac adverse events (1.84% vs 3.53%; P 1/4 0.254) between LAST and non-LAST cases. However, on multivariable analysis, the use of LAST was associated with lower procedural success (OR: 0.61; 95% CI: 0.41-0.91). Primary LAST was associated with higher technical (76.4% vs 55.6%; P 1/4 0.014) and procedural (75.6% vs 50.0%; P 1/4 0.003) success and similar major adverse cardiac event (1.57% vs 2.78%; P 1/4 0.636) rates compared with secondary LAST.CONCLUSIONS LAST was used in 11.1% of antegrade re-entry CTO PCI cases and was associated with lower procedural success on multivariable analysis, suggesting a limited role of LAST in contemporary CTO PCI. (J Am Coll Cardiol Intv 2022;15:2284-2293) (c) 2022 by the American College of Cardiology Foundation.

Published
2022
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29. URGENT MECHANICAL CIRCULATORY SUPPORT SCORE IN CHRONIC TOTAL OCCLUSION PERCUTANEOUS CORONARY INTERVENTION

Author

Judit Karacsonyi, Larissa Stanberry, Bahadir Simsek, Spyridon Kostantinis, Salman S. Allana, Khaldoon Alaswad, Farouc A. Jaffer, Paul Poommipanit, Jaikirshan J. Khatri, Mitul P. Patel, Abdul Sheikh, Jason R. Wollmuth, Barry F. Uretsky, Robert W. Yeh, Raj H. Chandwaney, Athanasios Rempakos, Ahmed Mohamed ElGuindy, Nidal Abi Rafeh, Yader Sandoval, M Nicholas Burke, Olga Mastrodemos, Brynn Okeson, Bavana V. Rangan, Imre Ungi, and Emmanouil S. Brilakis

Subjects
Cardiology and Cardiovascular Medicine
Published
2023
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30. CONTEMPORARY OUTCOMES OF CHRONIC TOTAL OCCLUSION INTERVENTIONS: UPDATE FROM THE PROGRESS-CTO (PROSPECTIVE GLOBAL REGISTRY FOR THE STUDY OF CHRONIC TOTAL OCCLUSION INTERVENTION) INTERNATIONAL REGISTRY

Author

Salman S. Allana, Spyridon Kostantinis, Bahadir Simsek, Judit Karacsonyi, Khaldoon Alaswad, Athanasios Rempakos, Dmitrii Khelimskii, Dimitrios I. Karmpaliotis, Farouc A. Jaffer, Jaikirshan J. Khatri, Paul Poommipanit, James W. Choi, Mitul P. Patel, Michail Koutouzis, Ehtisham Mahmud, Basem Elbarouni, Wissam A. Jaber, Stéphane Rinfret, Srinivasa P. Potluri, William J. Nicholson, Brian K. Jefferson, Sevket Gorgulu, Raj H. Chandwaney, Bavana V. Rangan, and Emmanouil S. Brilakis

Subjects
Cardiology and Cardiovascular Medicine
Published
2023
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31. IMPACT OF QUALITY OF DISTAL TARGET VESSEL ON THE OUTCOMES OF CHRONIC TOTAL OCCLUSION INTERVENTION: INSIGHTS FROM THE PROGRESS-CTO REGISTRY

Author

Salman S. Allana, Spyridon Kostantinis, Judit Karacsonyi, Bahadir Simsek, Paul Poommipanit, Jaikirshan J. Khatri, James W. Choi, Khaldoon Alaswad, Stéphane Rinfret, Wissam A. Jaber, William J. Nicholson, Oleg Krestianinov, Dmitrii Khelimskii, Dimitrios I. Karmpaliotis, Farouc A. Jaffer, Mitul P. Patel, Ehtisham Mahmud, Michail Koutouzis, Basem Elbarouni, Yader Sandoval, Ufuk Yildirim, Barry F. Uretsky, Korhan Soylu, Bavana V. Rangan, and Emmanouil S. Brilakis

Subjects
Cardiology and Cardiovascular Medicine
Published
2023
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32. LESION COMPLEXITY AND PROCEDURAL OUTCOMES ASSOCIATED WITH OSTIAL CHRONIC TOTAL OCCLUSIONS: INSIGHTS FROM THE PROGRESS-CTO REGISTRY

Author

Salman S. Allana, Spyridon Kostantinis, Bahadir Simsek, Judit Karacsonyi, Khaldoon Alaswad, Paul Poommipanit, Jaikirshan J. Khatri, James W. Choi, Athanasios Rempakos, Oleg Krestianinov, Dmitrii Khelimskii, Dimitrios I. Karmpaliotis, Farouc A. Jaffer, Rhian E. Davies, Rodrigo Bagur, Sevket Gorgulu, Srinivasa P. Potluri, Yader Sandoval, Ehtisham Mahmud, Mitul P. Patel, Brian K. Jefferson, Raj H. Chandwaney, M Nicholas Burke, Bavana V. Rangan, and Emmanouil S. Brilakis

Subjects
Cardiology and Cardiovascular Medicine
Published
2023
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33. OUTCOMES OF PATIENTS WITH ACUTE CORONARY SYNDROMES UNDERGOING CHRONIC TOTAL OCCLUSION PERCUTANEOUS CORONARY INTERVENTION

Author

Bahadir Simsek, Spyridon Kostantinis, Judit Karacsonyi, Khaldoon Alaswad, Farouc A. Jaffer, Darshan Doshi, Jaikirshan J. Khatri, Paul Poommipanit, Sevket Gorgulu, Nazif Aygul, Nidal Abi Rafeh, Oleg Krestianinov, James W. Choi, Barry F. Uretsky, Rhian E. Davies, Omer Goktekin, Ahmed Mohamed ElGuindy, Brian K. Jefferson, Mitul P. Patel, Bavana V. Rangan, Athanasios Rempakos, Salman S. Allana, Yader Sandoval, M. Nicholas Burke, and Emmanouil S. Brilakis

Subjects
Cardiology and Cardiovascular Medicine
Published
2023
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34. EFFECT OF OCCLUSION LESION AGE ON OUTCOMES OF CHRONIC TOTAL OCCLUSION PERCUTANEOUS CORONARY INTERVENTION

Author

Judit Karacsonyi, Spyridon Kostantinis, Bahadir Simsek, Salman S. Allana, Athanasios Rempakos, Jaikirshan J. Khatri, Oleg Krestianinov, Farouc A. Jaffer, Khaldoon Alaswad, Ahmed Mohamed ElGuindy, Brian K. Jefferson, Sevket Gorgulu, Paul Poommipanit, Dimitri Karmpaliotis, Ajay J. Kirtane, Margaret McEntegart, James W. Choi, Nidal Abi Rafeh, Omer Goktekin, Yader Sandoval, M Nicholas Burke, Olga Mastrodemos, Bavana V. Rangan, Imre Ungi, and Emmanouil S. Brilakis

Subjects
Cardiology and Cardiovascular Medicine
Published
2023
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35. EQUIPMENT UTILIZATION IN CHRONIC TOTAL OCCLUSION PERCUTANEOUS CORONARY INTERVENTIONS: INSIGHTS FROM THE PROGRESS-CTO REGISTRY

Author

Spyridon Kostantinis, Bahadir Simsek, Judit Karacsonyi, Khaldoon Alaswad, Farouc A. Jaffer, Jaikirshan J. Khatri, Paul Poommipanit, Rhian E. Davies, Stéphane Rinfret, Wissam A. Jaber, James W. Choi, Mitul P. Patel, Brian K. Jefferson, Jimmy L. Kerrigan, Basem Elbarouni, Nidal Abi Rafeh, Omer Goktekin, Ahmed Mohamed ElGuindy, Salman S. Allana, Olga Mastrodemos, Athanasios Rempakos, Bavana V. Rangan, Yader Sandoval, M Nicholas Burke, and Emmanouil S. Brilakis

Subjects
Cardiology and Cardiovascular Medicine
Published
2023
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36. TCT-123 Predictors of Success in Primary Retrograde Strategy in Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From the PROGRESS-CTO Registry

Author

Bahadir Simsek, Spyridon Kostantinis, Judit Karacsonyi, Khaldoon Alaswad, Dimitri Karmpaliotis, Farouc Jaffer, Jaikirshan Khatri, Paul Poommipanit, Sevket Gorgulu, Omer Goktekin, Oleg Krestyaninov, Rhian Davies, Ahmed ElGuindy, Elias Haddad, Jimmy Kerrigan, Mitul Patel, Raj Chandwaney, Olga Mastrodemos, Salman Allana, Bavana Rangan, and Emmanouil Brilakis

Subjects
Cardiology and Cardiovascular Medicine
Published
2022
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37. TCT-109 Use of Subintimal Tracking and Reentry Technique in Chronic Total Occlusion Percutaneous Coronary Intervention

Author

Judit Karacsonyi, Spyridon Kostantinis, Bahadir Simsek, Khaldoon Alaswad, Dimitri Karmpaliotis, Ajay Kirtane, Margaret McEntegart, Farouc Jaffer, James Choi, Paul Poommipanit, Michalis Koutouzis, Ioannis Tsiafoutis, Jaikirshan Khatri, David Kandzari, Raj Chandwaney, Basem Elbarouni, Sevket Gorgulu, Ahmed ElGuindy, Nidal Abi-Rafeh, Omer Goktekin, Imre Ungi, Bavana Rangan, Olga Mastrodemos, Yader Sandoval, Salman Allana, M. Nicholas Burke, and Emmanouil Brilakis

Subjects
Cardiology and Cardiovascular Medicine
Published
2022
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38. TCT-117 Impact of Proximal Cap Ambiguity on the Outcomes of Chronic Total Occlusion Intervention: Insights From the PROGRESS-CTO Registry

Author

Spyridon Kostantinis, Bahadir Simsek, Judit Karacsonyi, Khaldoon Alaswad, Michael Megaly, Oleg Krestyaninov, Dmitrii Khelimskii, Farouc Jaffer, Jaikirshan Khatri, Paul Poommipanit, Mitul Patel, Ehtisham Mahmud, Michail Koutouzis, Ioannis Tsiafoutis, Sevket Gorgulu, Basem Elbarouni, William Nicholson, Wissam Jaber, Stephane Rinfret, Omer Goktekin, Ahmed ElGuindy, Yader Sandoval, M. Nicholas Burke, Salman Allana, Bavana Rangan, and Emmanouil Brilakis

Subjects
Cardiology and Cardiovascular Medicine
Published
2022
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39. Abstract 11342: Contemporary in-hospital Outcomes of Chronic Total Occlusion Interventions: Update from the Progress-cto (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) International Registry

Author

Spyridon Kostantinis, Khaldoon Alaswad, Dimitrios Karmpaliotis, Oleg Krestyaninov, Dmitrii Khelimskii, James Choi, Farouc A Jaffer, Paul Poommipanit, Judit Karacsonyi, Evangelia Vemmou, Ilias Nikolakopoulos, Sevket Gorgulu, Michael Koutouzis, Ioannis Tsiafoutis, Robert Riley, Basem Elbarouni, Wissam Jaber, Habib Samady, Khalid Tammam, Ahmed M Elguindy, OMER GOKTEKIN, Nidal Abi-Rafeh, Bavana V Rangan, M Nicholas Burke, and Emmanouil S Brilakis

Subjects
Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract

Introduction: Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is an evolving field. Methods: We examined the clinical and angiographic characteristics and procedural outcomes of 8,666 CTO PCIs performed at 36 centers between 2012 and 2021. Results: Mean age was 64±10 years and 82% of the patients were men. The prevalence of prior PCI (62%) and diabetes mellitus (43%) was high. Median ejection fraction was 54% (42%, 60%). Radial access was used in 50%. The most common target vessel was the right coronary artery (52%), followed by the left anterior descending artery (26%). The target CTOs were highly complex with mean J-CTO score of 2.4 ±1.3 and PROGRESS score of (1.3 ±1). Technical and procedural success rates were high (86% and 85% respectively) with a relatively low percentage of in-hospital major adverse cardiac events (Figure 1). The final successful crossing strategy was antegrade wire escalation in 62%, retrograde in 22%, and antegrade dissection re-entry in 16%. Median contrast volume, air kerma radiation dose and procedure time were 220 (155, 300) ml, 2.2 (1.2, 3.8) Gray and 116 (75, 172) minutes, respectively. Conclusions: High success and acceptable complication rates can currently be achieved in CTO PCI among high-volume, experienced centers.

Published
2021
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40. Meta-Analysis of Percutaneous Coronary Intervention of Chronic Total Occlusions

Author

Hani Jneid, Hafeez Ul Hassan Virk, Zhen Wang, Chayakrit Krittanawong, Paul Poommipanit, and Mohammed Mhanna

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Percutaneous coronary intervention, Percutaneous Coronary Intervention, Coronary Occlusion, Meta-analysis, Internal medicine, Chronic Disease, Cardiology, Medicine, Humans, Cardiology and Cardiovascular Medicine, business
Published
2021

41. TCT-128 Saphenous Vein Graft Occlusion Following Native Vessel Chronic Total Occlusion Percutaneous Coronary Intervention

Author

Spyridon Kostantinis, Bahadir Simsek, Judit Karacsonyi, Khaldoon Alaswad, Michael Megaly, Farouc Jaffer, Jaikirshan Khatri, Paul Poommipanit, Rhian Davies, Stephane Rinfret, Basem Elbarouni, Luiz Ybarra, Abdul Sheikh, Catalin Toma, Raj Chandwaney, Omer Goktekin, Ahmed ElGuindy, Olga Mastrodemos, Bavana Rangan, M. Nicholas Burke, and Emmanouil Brilakis

Subjects
Cardiology and Cardiovascular Medicine
Published
2022
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42. TCT-112 Predicting In-Hospital Acute Myocardial Infarction in Chronic Total Occlusion Percutaneous Coronary Intervention: The PROGRESS-CTO Acute Myocardial Infarction Score

Author

Bahadir Simsek, Spyridon Kostantinis, Judit Karacsonyi, Khaldoon Alaswad, Oleg Krestyaninov, Dmitrii Khelimskii, Rhian Davies, Jeremy Rier, Omer Goktekin, Sevket Gorgulu, Ahmed ElGuindy, Raj Chandwaney, Mitul Patel, Dimitri Karmpaliotis, Jaikirshan Khatri, Farouc Jaffer, Paul Poommipanit, Bavana Rangan, Yader Sandoval, Basem Elbarouni, William Nicholson, Stephane Rinfret, Michail Koutouzis, Ioannis Tsiafoutis, Robert Yeh, M. Nicholas Burke, Salman Allana, Olga Mastrodemos, and Emmanouil Brilakis

Subjects
Cardiology and Cardiovascular Medicine
Published
2022
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43. TCT-171 Predicting the Risk of Perforation Requiring Pericardiocentesis in Chronic Total Occlusion Percutaneous Coronary Intervention: The PROGRESS-CTO Pericardiocentesis Score

Author

Bahadir Simsek, Spyridon Kostantinis, Judit Karacsonyi, Khaldoon Alaswad, Oleg Krestyaninov, Dmitrii Khelimskii, Rhian Davies, Jeremy Rier, Omer Goktekin, Sevket Gorgulu, Ahmed ElGuindy, Raj Chandwaney, Mitul Patel, Dimitri Karmpaliotis, Jaikirshan Khatri, Farouc Jaffer, Paul Poommipanit, Bavana Rangan, Yader Sandoval, Basem Elbarouni, William Nicholson, Stephane Rinfret, Michail Koutouzis, Ioannis Tsiafoutis, Robert Yeh, M. Nicholas Burke, Salman Allana, Olga Mastrodemos, and Emmanouil Brilakis

Subjects
Cardiology and Cardiovascular Medicine
Published
2022
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44. TCT-113 Predicting the Risk of In-Hospital Major Adverse Cardiovascular Events in Chronic Total Occlusion Percutaneous Coronary Intervention: The PROGRESS-CTO MACE Score

Author

Bahadir Simsek, Spyridon Kostantinis, Judit Karacsonyi, Khaldoon Alaswad, Oleg Krestyaninov, Dmitrii Khelimskii, Rhian Davies, Jeremy Rier, Omer Goktekin, Sevket Gorgulu, Ahmed ElGuindy, Raj Chandwaney, Mitul Patel, Dimitri Karmpaliotis, Jaikirshan Khatri, Farouc Jaffer, Paul Poommipanit, Bavana Rangan, Yader Sandoval, Basem Elbarouni, William Nicholson, Stephane Rinfret, Michail Koutouzis, Ioannis Tsiafoutis, Robert Yeh, M. Nicholas Burke, Salman Allana, and Emmanouil Brilakis

Subjects
Cardiology and Cardiovascular Medicine
Published
2022
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45. TCT-110 Use of Atherectomy in Chronic Total Occlusion Percutaneous Coronary Intervention

Author

Judit Karacsonyi, Bahadir Simsek, Spyridon Kostantinis, Khaldoon Alaswad, Oleg Krestyaninov, Dimitri Karmpaliotis, Ajay Kirtane, Margaret McEntegart, Jaikirshan Khatri, Paul Poommipanit, Farouc Jaffer, James Choi, Ehtisham Mahmud, Mitul Patel, Michalis Koutouzis, Ioannis Tsiafoutis, Basem Elbarouni, Wissam Jaber, Stephane Rinfret, Brian Jefferson, Taral Patel, Sevket Gorgulu, Ahmed ElGuindy, Nidal Abi-Rafeh, Omer Goktekin, Imre Ungi, Bavana Rangan, Olga Mastrodemos, Yader Sandoval, Salman Allana, M. Nicholas Burke, and Emmanouil Brilakis

Subjects
Cardiology and Cardiovascular Medicine
Published
2022
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46. Chronic total occlusion percutaneous coronary intervention during the COVID-19 pandemic: Insights from the PROGRESS-CTO registry

Author

Judit Karacsonyi, Oleg Krestyaninov, Emmanouil S. Brilakis, Dmitrii Khelimskii, Khaldoon Alaswad, Santiago Garcia, Jaikirshan Khatri, Evangelia Vemmou, Paul Poommipanit, and Ilias Nikolakopoulos

Subjects
medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), medicine.medical_treatment, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Coronary Angiography, Total occlusion, Coronary artery disease, angioplasty and stenting, Percutaneous Coronary Intervention, Risk Factors, Internal medicine, Correspondence, Pandemic, medicine, Diseases of the circulatory (Cardiovascular) system, Humans, Registries, Pandemics, business.industry, SARS-CoV-2, Percutaneous coronary intervention, COVID-19, medicine.disease, Treatment Outcome, Coronary Occlusion, Coronary occlusion, RC666-701, Chronic Disease, Cardiology, Cardiology and Cardiovascular Medicine, business, coronary artery disease
Published
2021

47. TCT-319 Use of Limited Antegrade Subintimal Tracking Technique in Chronic Total Occlusion Percutaneous Coronary Intervention

Author

Ioannis Tsiafoutis, Judit Karacsonyi, Farouc A. Jaffer, Robert Riley, Omer Goktekin, Imre Ungi, Vennela Avula, Bahadir Simsek, Dimitri Karmpaliotis, Alessandra Gutierrez, Spyridon Kostantinis, Ahmed ElGuindy, Basem Elbarouni, Paul Poommipanit, Sevket Gorgulu, Nidal Abi-Rafeh, David E. Kandzari, Khaldoon Alaswad, James W. Choi, Emmanouil S. Brilakis, and Jaikirshan Khatri

Subjects
medicine.medical_specialty, business.industry, Internal medicine, medicine.medical_treatment, medicine, Cardiology, Percutaneous coronary intervention, Cardiology and Cardiovascular Medicine, business, Total occlusion
Published
2021
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48. TCT-72 Primary Versus Secondary Retrograde Approach in Chronic Total Occlusion Interventions

Author

William J. Nicholson, Emmanouil S. Brilakis, Wissam Jaber, Stéphane Rinfret, Alessandra Gutierrez, Vennela Avula, Mitul Patel, Jaikirshan Khatri, Sevket Gorgulu, Khaldoon Alaswad, Farouc A. Jaffer, Santiago Garcia, M. Nicholas Burke, Dimitri Karmpaliotis, Spyridon Kostantinis, Omer Goktekin, Evangelia Vemmou, Paul Poommipanit, Abdul M. Sheikh, Bavana V. Rangan, Nidal Abi-Rafeh, Robert Riley, Ilias Nikolakopoulos, Ioannis Tsiafoutis, Judit Karacsonyi, and Ahmed ElGuindy

Subjects
medicine.medical_specialty, business.industry, Psychological intervention, Retrograde approach, Medicine, Cardiology and Cardiovascular Medicine, business, Total occlusion, Surgery
Published
2021
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49. E-30 | Meta-Analysis of Successful vs. Failed Chronic Total Occlusion Percutaneous Coronary Intervention

Author

Bahadir Simsek, Spyridon Kostantinis, Judit Karacsonyi, Khaldoon Alaswad, Dimitrios Karmpaliotis, Wissam A. Jaber, William J. Nicholson, Stéphane Rinfret, Kambis Mashayekhi, Gerald S. Werner, Margaret McEntegart, Seung W. Lee, Bo Xu, Jaikirshan Khatri, Scott A. Harding, Alexandre Avran, Farouc A. Jaffer, Darshan Doshi, Hsien-Li Kao, George Sianos, Masahisa Yamane, Anastasios Milkas, Lorenzo Azzalini, Roberto Garbo, Khalid Omar Tammam, Nidal Abi Rafeh, Ilias Nikolakopoulos, Evangelia Vemmou, Olga C. Mastrodemos, Bavana V. Rangan, M. Nicholas Burke, Santiago Garcia, Kevin J. Croce, Eugene B. Wu, Etsuo Tsuchikane, Carlo Di Mario, Alfredo R. Galassi Prof, Andrea Gagnor, Paul Knaapen, Yangsoo Jang, Byeong-Keuk Kim, Paul Poommipanit, and Emmanouil S. Brilakis

Published
2022
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50. E-15 | Gender Differences in Chronic Total Occlusion Percutaneous Coronary Interventions: Insights from the PROGRESS-CTO Registry

Author

Spyridon Kostantinis, Megha Prasad, Bahadir Simsek, Judit Karacsonyi, Khaldoon Alaswad, Mir B. Basir, Michael S. Megaly, Şevket Görgülü, Oleg Krestyaninov, Dmitrii Khelimskii, Stewart M. Benton, Rhian E. Davies, Jaikirshan Khatri, Farouc A. Jaffer, Paul Poommipanit, Brian Jefferson, Taral N. Patel, Philip Dattilo, M. Nicholas Burke, Santiago Garcia, Michail Koutouzis, Ioannis Tsiafoutis, Ahmed Elguindy, Ömer Göktekin, Nidal Abi Rafeh, Olga C. Mastrodemos, Bavana V. Rangan, and Emmanouil S. Brilakis

Published
2022
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