Single vs. multiple operators for chronic total occlusion percutaneous coronary interventions: From the PROGRESS-CTO Registry

被引：7

作者：

Karacsonyi, Judit ^{[1
,2
]}

Alaswad, Khaldoon ^{[3
]}

Krestyaninov, Oleg ^{[4
]}

Karmpaliotis, Dimitri ^{[5
]}

Kirtane, Ajay ^{[6
]}

Ali, Ziad ^{[7
]}

McEntegart, Margaret ^{[6
]}

Masoumi, Amirali ^{[5
]}

Poomipanit, Paul ^{[8
]}

Jaffer, Farouc A. ^{[9
]}

Khatri, Jaikirshan ^{[10
]}

Choi, James ^{[11
]}

Patel, Mitul ^{[12
]}

Koutouzis, Michalis ^{[13
]}

Tsiafoutis, Ioannis

Gorgulu, Sevket ^{[14
]}

Sheikh, Abdul M. ^{[15
]}

Elbarouni, Basem ^{[16
]}

Jaber, Wissam ^{[17
]}

ElGuindy, Ahmed ^{[18
]}

Yeh, Robert ^{[19
]}

Kostantinis, Spyridon ^{[1
,2
]}

Simsek, Bahadir ^{[1
,2
]}

Rangan, Bavana ^{[1
,2
]}

Mastrodemos, Olga C. ^{[1
,2
]}

Vemmou, Evangelia ^{[1
,2
]}

Nikolakopoulos, Ilias ^{[1
,2
]}

Ungi, Imre ^{[20
,21
]}

Rafeh, Nidal A. ^{[22
]}

Goktekin, Omer ^{[23
]}

Burke, M. Nicholas ^{[1
,2
]}

Brilakis, Emmanouil S. ^{[1
]}

Sandoval, Yader ^{[1
]}

机构：

[1] Abbott NW Hosp, Minneapolis Heart Inst, Minneapolis, MN USA

[2] Minneapolis Heart Inst Fdn, Minneapolis, MN USA

[3] Henry Ford Hosp, Detroit, MI USA

[4] Meshalkin Novosibirsk Res Inst, Novosibirsk, Russia

[5] Gagnon Cardiovasc Inst, Morristown Med Ctr, Morristown, NJ USA

[6] Columbia Univ, New York, NY USA

[7] St Francis Hosp & Heart Ctr, Roslyn, NY USA

[8] Case Western Reserve Univ, Univ Hosp, Harrington Heart & Vasc Inst, Cleveland Hts, OH USA

[9] Massachusetts Gen Hosp, Div Cardiol, Boston, MA USA

[10] Cleveland Clin, Dept Cardiovasc Med, Cleveland, OH USA

[11] Baylor Univ, Med Ctr, Baylor Heart & Vasc Hosp, Dallas, TX USA

[12] Univ Calif San Diego, Div Cardiovasc Med, La Jolla, CA USA

[13] Red Cross Hosp Athens, Dept Cardiol 2, Athens, Greece

[14] Biruni Univ, Med Sch, Dept Cardiol, Istanbul, Turkiye

[15] Wellstar Hlth Syst, Marietta, GA USA

[16] St Boniface Gen Hosp, Dept Internal Med, Sect Cardiol, Winnipeg, MB, Canada

[17] Emory Univ, Sch Med, Div Cardiol, Atlanta, GA USA

[18] Magdi Yacoub Fdn, Aswan Heart Ctr, Aswan, Egypt

[19] Beth Israel Deaconess Med Ctr, Boston, MA USA

[20] Univ Szeged, Dept Internal Med, Div Invas Cardiol, Szeged, Hungary

[21] Univ Szeged, Cardiol Ctr, Szeged, Hungary

[22] North Oaks Hlth Syst, Los Angeles, CA USA

[23] Mem Bahcelievler Hosp, Dept Cardiol, Istanbul, Turkiye

来源：

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS | 2023年 / 101卷 / 03期

关键词：

chronic total occlusion; clinical outcomes; operator; percutaneous coronary intervention;

D O I：

10.1002/ccd.30564

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BackgroundThere is limited data on the impact of a second attending operator on chronic total occlusion (CTO) percutaneous coronary intervention (PCI) outcomes. MethodsWe analyzed the association between multiple operators (MOs) (>1 attending operator) and procedural outcomes of 9296 CTO PCIs performed between 2012 and 2021 at 37 centers. ResultsCTO PCI was performed by a single operator (SO) in 85% of the cases and by MOs in 15%. Mean patient age was 64.4 +/- 10 years and 81% were men. SO cases were more complex with higher Japan-CTO (2.38 +/- 1.29 vs. 2.28 +/- 1.20, p = 0.005) and Prospective Global Registry for the Study of Chronic Total Occlusion Intervention scores (1.13 +/- 1.01 vs. 0.97 +/- 0.93, p < 0.001) compared with MO cases. Procedural time (131 [87, 181] vs. 112 [72, 167] min, p < 0.001), fluoroscopy time (49 [31, 76] vs. 42 [25, 68] min, p < 0.001), air kerma radiation dose (2.32 vs. 2.10, p < 0.001), and contrast volume (230 vs. 210, p < 0.001) were higher in MO cases. Cases performed by MOs and SO had similar technical (86% vs. 86%, p = 0.9) and procedural success rates (84% vs. 85%, p = 0.7), as well as major adverse complication event rates (MACE 2.17% vs. 2.42%, p = 0.6). On multivariable analyses, MOs were not associated with higher technical success or lower MACE rates. ConclusionIn a contemporary, multicenter registry, 15% of CTO PCI cases were performed by multiple operators. Despite being more complex, SO cases had lower procedural and fluoroscopy times, and similar technical and procedural success and risk of complications compared with MO cases.

引用

页码：543 / 552

页数：10

共 17 条

[1] A novel maneuver to facilitate retrograde wire externalization during retrograde chronic total occlusion percutaneous coronary intervention [J].

Carlino, Mauro ;

Azzalini, Lorenzo ;

Colombo, Antonio .

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2017, 89 (01) :E7-E12

[2] Development and Validation of a Novel Scoring System for Predicting Technical Success of Chronic Total Occlusion Percutaneous Coronary Interventions The PROGRESS CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) Score [J].

Christopoulos, Georgios ;

Kandzari, David E. ;

Yeh, Robert W. ;

Jaffer, Farouc A. ;

Karmpaliotis, Dimitri ;

Wyman, Michael R. ;

Alaswad, Khaldoon ;

Lombardi, William ;

Grantham, J. Aaron ;

Moses, Jeffrey ;

Christakopoulos, Georgios ;

Rangan, Bavana V. ;

Lembo, Nicholas ;

Garcia, Santiago ;

Cipher, Daisha ;

Thompson, Craig A. ;

Banerjee, Subhash ;

Brilakis, Emmanouil S. .

JACC-CARDIOVASCULAR INTERVENTIONS, 2016, 9 (01) :1-9

[3] A Case-Based Illustration of a Dual-Operator, Dual Microcatheter Technique for Side Branch Wiring [J].

Hall, Allison B. ;

Xenogiannis, Iosif ;

Burke, M. Nicholas ;

Brilakis, Emmanouil S. .

CARDIOVASCULAR REVASCULARIZATION MEDICINE, 2019, 20 (11) :S21-S25

[4] Research electronic data capture (REDCap)-A metadata-driven methodology and workflow process for providing translational research informatics support [J].

Harris, Paul A. ;

Taylor, Robert ;

Thielke, Robert ;

Payne, Jonathon ;

Gonzalez, Nathaniel ;

Conde, Jose G. .

JOURNAL OF BIOMEDICAL INFORMATICS, 2009, 42 (02) :377-381

[5]

Jaffe AS, 2013, CLIN BIOCHEM, V46, P1, DOI [10.1093/eurheartj/ehs184, 10.1016/j.clinbiochem.2012.10.036, 10.1161/CIR.0b013e31826e1058, 10.1016/j.jacc.2012.08.001, 10.1016/j.gheart.2018.08.004, 10.1016/j.gheart.2012.08.001, 10.5603/KP.2018.0203]

[6] Development of a high-volume, multiple-operator program for percutaneous chronic total coronary occlusion revascularization: procedural, clinical, and cost-utilization outcomes [J].

Karmpaliotis, Dimitri ;

Lembo, Nicholas ;

Kalynych, Anna ;

Carlson, Harold ;

Lombardi, William L. ;

Anderson, Chad N. ;

Rinehart, Sarah ;

Kirkland, Ben ;

Shemwell, Kathie C. ;

Kandzari, David E. .

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2013, 82 (01) :1-8

[7] Chronic Total Occlusions Practice Makes Perfect-Implications for Standardizing Performance and Training [J].

Kaul, Prashant ;

Kandzari, David E. .

CIRCULATION-CARDIOVASCULAR INTERVENTIONS, 2020, 13 (08)

[8]

Knaapen P, 2021, NETH HEART J, V29, P1, DOI 10.1007/s12471-020-01531-w

[9] Temporal Trends in Chronic Total Occlusion Interventions in Europe 17626 Procedures From the European Registry of Chronic Total Occlusion [J].

Konstantinidis, Nikolaos V. ;

Werner, Gerald S. ;

Deftereos, Spyridon ;

Di Mario, Carlo ;

Galassi, Alfredo R. ;

Buettner, Joachim H. ;

Avran, Alexandre ;

Reifart, Nicolaus ;

Goktekin, Omer ;

Garbo, Roberto ;

Bufe, Alexander ;

Mashayekhi, Kambis ;

Boudou, Nicolas ;

Meyer-Gessner, Markus ;

Lauer, Bernward ;

Elhadad, Simon ;

Christiansen, Evald H. ;

Escaned, Javier ;

Hildick-Smith, David ;

Carlino, Mauro ;

Louvard, Yves ;

Lefevre, Thierry ;

Angelis, Lefteris ;

Giannopoulos, Georgios ;

Sianos, Georgios .

CIRCULATION-CARDIOVASCULAR INTERVENTIONS, 2018, 11 (10)

[10] Clinical Characteristics and Outcomes Among Patients Undergoing High-Risk Percutaneous Coronary Interventions by Single or Multiple Operators: Insights From the Veterans Affairs Clinical Assessment, Reporting, and Tracking Program [J].

Kovach, Christopher P. ;

Hebbe, Annika ;

Baron, Anna E. ;

Strobel, Aaron ;

Plomondon, Mary E. ;

Valle, Javier A. ;

Waldo, Stephen W. .

JOURNAL OF THE AMERICAN HEART ASSOCIATION, 2021, 10 (23)

← 1 2 →