Adoption of the hybrid CTO approach by a single non-CTO operator: procedural and clinical outcomes.
Bibliographic record
Abstract
BACKGROUND: The feasibility of adopting the "hybrid" approach by a single operator without prior experience in percutaneous coronary intervention (PCI) of chronic total occlusions (CTOs) has not been described. METHODS: Consecutive patients who underwent CTO-PCI by a single operator using the "hybrid" approach between 2012 and 2013 formed the analytic cohort. No patient was declined on the basis of angiographic findings. Clinical and angiographic characteristics together with procedural and hospital outcomes are described. RESULTS: During the study period, a total of 48 consecutive patients underwent PCI of 50 CTOs. Mean age was 63.4 ± 9.4 years and most patients (83%) were men. The right coronary artery (RCA) was the most commonly treated CTO vessel (54%) and mean J-CTO score was 2.3 ± 1.1. A primary retrograde approach was chosen for 33% of lesions and 40% required use of an epicardial collateral vessel. The primary strategy was effective in 65% of successful cases, 35% required one change in strategy, and 15% requiring two strategy changes. Procedural success rate was 92%. The median number of stents used was 3 (interquartile range [IQR], 2-4] and the total stent length was 73 mm [IQR, 38-96 mm). Mean contrast volume was 356.4 ± 148.3 mL and the mean air kerma radiation exposure was 3.5 ± 2.0 Gy. No patient experienced a major periprocedural complication. CONCLUSION: The "hybrid" approach to CTO-PCI can be successfully adopted by a single operator with excellent early procedural success and low complication rates, despite a lack of prior CTO-PCI experience.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".