E-11 | Single vs. Multiple Operators for Chronic Total Occlusion Percutaneous Coronary Interventions
Notice bibliographique
Résumé
BackgroundThere is limited data on the impact of a second operator on chronic total occlusion (CTO) percutaneous coronary intervention (PCI) outcomes.MethodsWe analyzed the association between multiple operators (MO) (>1 attending operator), and procedural outcomes of 9,296 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 MO 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 PROGRESS CTO (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 cases performed by MO. Procedural times (131 [87, 181] vs. 112 [72, 167] min, p<0.001), fluoroscopy times (49 [31, 76] vs. 42 [25, 68] min, p<0.001), air kerma (2.32 vs. 2.10, p<0.001), and contrast volumes (230 vs. 210, p<0.001) were higher in MO cases compared to SO. Cases performed by MO 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 multiple operators was not associated with higher technical success, or lower MACE rates (Figure 1).ConclusionsDisclosuresK. Alaswad: consultant and speaker for Boston Scientific, Abbott Cardiovascular, Teleflex, and CSI: Consulting; D. Karmpaliotis: Abbott: Speaker Bureau; Boston Scientific Corp.: Speaker Bureau; Saranas: Ownership Interests: Stocks, Stock Options; Soundbite: Ownership Interests: Stocks, Stock Options; Traverse Vascular: Ownership Interests: Stocks, Stock Options; Z. A. Ali: Abbott: Advisory Board/Board Member; Boston Scientific Corp.: Consulting and Speaker Bureau; Cardiovascular Systems, Inc.: Principal Investigator for a Research Study; Amgen: Advisory Board/Board Member; Astra Zeneca: Speaker Bureau; Shockwave Medical: Ownership Interests: Stocks, Stock Options; F. A. Jaffer: sponsored research support from Kowa, Canon, Siemens, Teleflex, Shockwave, and Amarin; consultant for Boston Scientific, Abbott Vascular, Siemens, Magenta Medical, Asahi Intecc and IMDS; has an equity interest in Intravascular Imaging, Inc. and DurVena, I: Consulting; J. Khatri: Medtronic, Abbott, Boston, Terumo, Asahi speaker/proctor.: Consulting; M. P. Patel: Abbott: Consulting; Cardiovascular Systems, Inc.: Consulting; Medtronic: Consulting; W. A. Jaber: consultant for Inari: Consulting; A. Elguindy: Honoraria: Medtronic, Boston Scientific, Asahi Intecc, Abbott Proctorship fees: Medtronic, Boston Scientific, Asahi Intecc, Terumo Educational grants: Medtronic: Consulting; K. O. Tammam: Terumo: Consulting; E. S. Brilakis: Abbott: Consulting and Speaker Bureau; AMgen: Consulting and Speaker Bureau; Asahi Intecc: Speaker Bureau; Biotronik: Consulting and Speaker Bureau; Boston Scientific Corp.: Consulting, Principal Investigator for a Research Study and Speaker Bureau; ControlRad: Speaker Bureau; CSI: Consulting and Speaker Bureau; GE Healthcare: Consulting, Principal Investigator for a Research Study and Speaker Bureau; Hippocrates LLC: Ownership Interests: Stocks, Stock Options; MHI Ventures: Ownership Interests: Stocks, Stock Options; Cleerly Health: Ownership Interests: Stocks, Stock Options; Stallion Medical: Ownership Interests: Stocks, Stock Options; J. Karacsonyi Nothing to disclose. O. Krestyaninov Nothing to disclose. A. J. Kirtane Nothing to disclose. M. McEntegart Nothing to disclose. A. Masoumi Nothing to disclose. P. Poomipanit Nothing to disclose. J. W. Choi Nothing to disclose. M. Koutouzis Nothing to disclose. I. Tsiafoutis Nothing to disclose. Ş. Görgülü Nothing to disclose. A. Doing Nothing to disclose. A. M. Sheikh Nothing to disclose. B. Elbarouni Nothing to disclose. R. W. Yeh Nothing to disclose. S. Kostantinis Nothing to disclose. B. Simsek Nothing to disclose. B. V. Rangan Nothing to disclose. O. C. Mastrodemos Nothing to disclose. E. Vemmou Nothing to disclose. I. Nikolakopoulos Nothing to disclose. I. Ungi Nothing to disclose. N. Abi Rafeh Nothing to disclose. Ö. Göktekin Nothing to disclose. Y. B. Sandoval Nothing to disclose. BackgroundThere is limited data on the impact of a second operator on chronic total occlusion (CTO) percutaneous coronary intervention (PCI) outcomes. There is limited data on the impact of a second operator on chronic total occlusion (CTO) percutaneous coronary intervention (PCI) outcomes. MethodsWe analyzed the association between multiple operators (MO) (>1 attending operator), and procedural outcomes of 9,296 CTO PCIs performed between 2012 and 2021 at 37 centers. We analyzed the association between multiple operators (MO) (>1 attending operator), and procedural outcomes of 9,296 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 MO 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 PROGRESS CTO (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 cases performed by MO. Procedural times (131 [87, 181] vs. 112 [72, 167] min, p<0.001), fluoroscopy times (49 [31, 76] vs. 42 [25, 68] min, p<0.001), air kerma (2.32 vs. 2.10, p<0.001), and contrast volumes (230 vs. 210, p<0.001) were higher in MO cases compared to SO. Cases performed by MO 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 multiple operators was not associated with higher technical success, or lower MACE rates (Figure 1). CTO PCI was performed by a single operator (SO) in 85% of the cases and by MO 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 PROGRESS CTO (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 cases performed by MO. Procedural times (131 [87, 181] vs. 112 [72, 167] min, p<0.001), fluoroscopy times (49 [31, 76] vs. 42 [25, 68] min, p<0.001), air kerma (2.32 vs. 2.10, p<0.001), and contrast volumes (230 vs. 210, p<0.001) were higher in MO cases compared to SO. Cases performed by MO 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 multiple operators was not associated with higher technical success, or lower MACE rates (Figure 1). Conclusions DisclosuresK. Alaswad: consultant and speaker for Boston Scientific, Abbott Cardiovascular, Teleflex, and CSI: Consulting; D. Karmpaliotis: Abbott: Speaker Bureau; Boston Scientific Corp.: Speaker Bureau; Saranas: Ownership Interests: Stocks, Stock Options; Soundbite: Ownership Interests: Stocks, Stock Options; Traverse Vascular: Ownership Interests: Stocks, Stock Options; Z. A. Ali: Abbott: Advisory Board/Board Member; Boston Scientific Corp.: Consulting and Speaker Bureau; Cardiovascular Systems, Inc.: Principal Investigator for a Research Study; Amgen: Advisory Board/Board Member; Astra Zeneca: Speaker Bureau; Shockwave Medical: Ownership Interests: Stocks, Stock Options; F. A. Jaffer: sponsored research support from Kowa, Canon, Siemens, Teleflex, Shockwave, and Amarin; consultant for Boston Scientific, Abbott Vascular, Siemens, Magenta Medical, Asahi Intecc and IMDS; has an equity interest in Intravascular Imaging, Inc. and DurVena, I: Consulting; J. Khatri: Medtronic, Abbott, Boston, Terumo, Asahi speaker/proctor.: Consulting; M. P. Patel: Abbott: Consulting; Cardiovascular Systems, Inc.: Consulting; Medtronic: Consulting; W. A. Jaber: consultant for Inari: Consulting; A. Elguindy: Honoraria: Medtronic, Boston Scientific, Asahi Intecc, Abbott Proctorship fees: Medtronic, Boston Scientific, Asahi Intecc, Terumo Educational grants: Medtronic: Consulting; K. O. Tammam: Terumo: Consulting; E. S. Brilakis: Abbott: Consulting and Speaker Bureau; AMgen: Consulting and Speaker Bureau; Asahi Intecc: Speaker Bureau; Biotronik: Consulting and Speaker Bureau; Boston Scientific Corp.: Consulting, Principal Investigator for a Research Study and Speaker Bureau; ControlRad: Speaker Bureau; CSI: Consulting and Speaker Bureau; GE Healthcare: Consulting, Principal Investigator for a Research Study and Speaker Bureau; Hippocrates LLC: Ownership Interests: Stocks, Stock Options; MHI Ventures: Ownership Interests: Stocks, Stock Options; Cleerly Health: Ownership Interests: Stocks, Stock Options; Stallion Medical: Ownership Interests: Stocks, Stock Options; J. Karacsonyi Nothing to disclose. O. Krestyaninov Nothing to disclose. A. J. Kirtane Nothing to disclose. M. McEntegart Nothing to disclose. A. Masoumi Nothing to disclose. P. Poomipanit Nothing to disclose. J. W. Choi Nothing to disclose. M. Koutouzis Nothing to disclose. I. Tsiafoutis Nothing to disclose. Ş. Görgülü Nothing to disclose. A. Doing Nothing to disclose. A. M. Sheikh Nothing to disclose. B. Elbarouni Nothing to disclose. R. W. Yeh Nothing to disclose. S. Kostantinis Nothing to disclose. B. Simsek Nothing to disclose. B. V. Rangan Nothing to disclose. O. C. Mastrodemos Nothing to disclose. E. Vemmou Nothing to disclose. I. Nikolakopoulos Nothing to disclose. I. Ungi Nothing to disclose. N. Abi Rafeh Nothing to disclose. Ö. Göktekin Nothing to disclose. Y. B. Sandoval Nothing to disclose. K. Alaswad: consultant and speaker for Boston Scientific, Abbott Cardiovascular, Teleflex, and CSI: Consulting; D. Karmpaliotis: Abbott: Speaker Bureau; Boston Scientific Corp.: Speaker Bureau; Saranas: Ownership Interests: Stocks, Stock Options; Soundbite: Ownership Interests: Stocks, Stock Options; Traverse Vascular: Ownership Interests: Stocks, Stock Options; Z. A. Ali: Abbott: Advisory Board/Board Member; Boston Scientific Corp.: Consulting and Speaker Bureau; Cardiovascular Systems, Inc.: Principal Investigator for a Research Study; Amgen: Advisory Board/Board Member; Astra Zeneca: Speaker Bureau; Shockwave Medical: Ownership Interests: Stocks, Stock Options; F. A. Jaffer: sponsored research support from Kowa, Canon, Siemens, Teleflex, Shockwave, and Amarin; consultant for Boston Scientific, Abbott Vascular, Siemens, Magenta Medical, Asahi Intecc and IMDS; has an equity interest in Intravascular Imaging, Inc. and DurVena, I: Consulting; J. Khatri: Medtronic, Abbott, Boston, Terumo, Asahi speaker/proctor.: Consulting; M. P. Patel: Abbott: Consulting; Cardiovascular Systems, Inc.: Consulting; Medtronic: Consulting; W. A. Jaber: consultant for Inari: Consulting; A. Elguindy: Honoraria: Medtronic, Boston Scientific, Asahi Intecc, Abbott Proctorship fees: Medtronic, Boston Scientific, Asahi Intecc, Terumo Educational grants: Medtronic: Consulting; K. O. Tammam: Terumo: Consulting; E. S. Brilakis: Abbott: Consulting and Speaker Bureau; AMgen: Consulting and Speaker Bureau; Asahi Intecc: Speaker Bureau; Biotronik: Consulting and Speaker Bureau; Boston Scientific Corp.: Consulting, Principal Investigator for a Research Study and Speaker Bureau; ControlRad: Speaker Bureau; CSI: Consulting and Speaker Bureau; GE Healthcare: Consulting, Principal Investigator for a Research Study and Speaker Bureau; Hippocrates LLC: Ownership Interests: Stocks, Stock Options; MHI Ventures: Ownership Interests: Stocks, Stock Options; Cleerly Health: Ownership Interests: Stocks, Stock Options; Stallion Medical: Ownership Interests: Stocks, Stock Options; J. Karacsonyi Nothing to disclose. O. Krestyaninov Nothing to disclose. A. J. Kirtane Nothing to disclose. M. McEntegart Nothing to disclose. A. Masoumi Nothing to disclose. P. Poomipanit Nothing to disclose. J. W. Choi Nothing to disclose. M. Koutouzis Nothing to disclose. I. Tsiafoutis Nothing to disclose. Ş. Görgülü Nothing to disclose. A. Doing Nothing to disclose. A. M. Sheikh Nothing to disclose. B. Elbarouni Nothing to disclose. R. W. Yeh Nothing to disclose. S. Kostantinis Nothing to disclose. B. Simsek Nothing to disclose. B. V. Rangan Nothing to disclose. O. C. Mastrodemos Nothing to disclose. E. Vemmou Nothing to disclose. I. Nikolakopoulos Nothing to disclose. I. Ungi Nothing to disclose. N. Abi Rafeh Nothing to disclose. Ö. Göktekin Nothing to disclose. Y. B. Sandoval Nothing to disclose.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,017 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,056 | 0,004 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».