E-11 | Single vs. Multiple Operators for Chronic Total Occlusion Percutaneous Coronary Interventions
Bibliographic record
Abstract
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.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.336 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 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".