E-17 | 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
Bibliographic record
Abstract
BackgroundChronic total occlusion (CTO) percutaneous coronary intervention (PCI) has been rapidly evolving.MethodsWe examined the clinical and angiographic characteristics and procedural outcomes of 10,249 CTO PCIs performed in 10,019 patients at 40 centers between 2012 and 2022.ResultsMean age was 64±10 years and 81% of the patients were men. The prevalence of prior PCI (62%), prior coronary artery bypass graft surgery (29%) and diabetes mellitus (43%) was high. Median ejection fraction was 55% (43%, 60%). The most common target vessel was the right coronary artery (53%), followed by the left anterior descending artery (26%) and left circumflex artery (19%). The target CTOs were highly complex with mean J-CTO score of 2.4 ±1.3 and PROGRESS-CTO score of 1.3 ±1. Technical and procedural success rates were high (86% and 85%, respectively) with a relatively low incidence (2%) of in-hospital major adverse cardiac events. The final successful crossing strategy was antegrade wire escalation in 55%, retrograde in 19%, and antegrade dissection re-entry in 12% (Figure). Median contrast volume, air kerma radiation dose and procedure time were 215 (150, 300) ml, 2.2 (1.2, 3.7) Gray and 114 (74, 168) minutes, respectively.ConclusionsDisclosuresK. Alaswad: consultant and speaker for Boston Scientific, Abbott Cardiovascular, Teleflex, and CSI: Consulting; M. B. Basir: consultant for Abbott Vascular, Abiomed, Cardiovascular Systems, Chiesi, and Zoll.: 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; 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; E. Mahmud: Abbott: Principal Investigator for a Research Study; Abiomed: Consulting; Cardiovascular Systems, Inc.: Principal Investigator for a Research Study; Medtronic: Consulting; CSI: Principal Investigator for a Research Study; Microport: Principal Investigator for a Research Study; W. J. Nicholson: Dr. Nicholson has served as proctor, consultant, and advisory board member for Abbott Vascular, Boston Scientific and Medtronic.: Consulting; W. A. Jaber: consultant for Inari: Consulting; S. Rinfret: Prof Rinfret has been a consultant for Boston Scientific, Teleflex, Medtronic, Abbott, and Abiomed.: Consulting; A. Elguindy: Honoraria: Medtronic, Boston Scientific, Asahi Intecc, Abbott Proctorship fees: Medtronic, Boston Scientific, Asahi Intecc, Terumo Educational grants: Medtronic: 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; S. Kostantinis Nothing to disclose. B. Simsek Nothing to disclose. J. Karacsonyi Nothing to disclose. M. S. Megaly Nothing to disclose. O. Krestyaninov Nothing to disclose. D. Khelimskii Nothing to disclose. P. Poommipanit Nothing to disclose. M. Koutouzis Nothing to disclose. I. Tsiafoutis Nothing to disclose. J. W. Choi Nothing to disclose. P. Dattilo Nothing to disclose. Ş. Görgülü Nothing to disclose. B. Elbarouni Nothing to disclose. N. Abi Rafeh Nothing to disclose. Ö. Göktekin Nothing to disclose. O. C. Mastrodemos Nothing to disclose. B. V. Rangan Nothing to disclose. BackgroundChronic total occlusion (CTO) percutaneous coronary intervention (PCI) has been rapidly evolving. Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has been rapidly evolving. MethodsWe examined the clinical and angiographic characteristics and procedural outcomes of 10,249 CTO PCIs performed in 10,019 patients at 40 centers between 2012 and 2022. We examined the clinical and angiographic characteristics and procedural outcomes of 10,249 CTO PCIs performed in 10,019 patients at 40 centers between 2012 and 2022. ResultsMean age was 64±10 years and 81% of the patients were men. The prevalence of prior PCI (62%), prior coronary artery bypass graft surgery (29%) and diabetes mellitus (43%) was high. Median ejection fraction was 55% (43%, 60%). The most common target vessel was the right coronary artery (53%), followed by the left anterior descending artery (26%) and left circumflex artery (19%). The target CTOs were highly complex with mean J-CTO score of 2.4 ±1.3 and PROGRESS-CTO score of 1.3 ±1. Technical and procedural success rates were high (86% and 85%, respectively) with a relatively low incidence (2%) of in-hospital major adverse cardiac events. The final successful crossing strategy was antegrade wire escalation in 55%, retrograde in 19%, and antegrade dissection re-entry in 12% (Figure). Median contrast volume, air kerma radiation dose and procedure time were 215 (150, 300) ml, 2.2 (1.2, 3.7) Gray and 114 (74, 168) minutes, respectively. Mean age was 64±10 years and 81% of the patients were men. The prevalence of prior PCI (62%), prior coronary artery bypass graft surgery (29%) and diabetes mellitus (43%) was high. Median ejection fraction was 55% (43%, 60%). The most common target vessel was the right coronary artery (53%), followed by the left anterior descending artery (26%) and left circumflex artery (19%). The target CTOs were highly complex with mean J-CTO score of 2.4 ±1.3 and PROGRESS-CTO score of 1.3 ±1. Technical and procedural success rates were high (86% and 85%, respectively) with a relatively low incidence (2%) of in-hospital major adverse cardiac events. The final successful crossing strategy was antegrade wire escalation in 55%, retrograde in 19%, and antegrade dissection re-entry in 12% (Figure). Median contrast volume, air kerma radiation dose and procedure time were 215 (150, 300) ml, 2.2 (1.2, 3.7) Gray and 114 (74, 168) minutes, respectively. Conclusions DisclosuresK. Alaswad: consultant and speaker for Boston Scientific, Abbott Cardiovascular, Teleflex, and CSI: Consulting; M. B. Basir: consultant for Abbott Vascular, Abiomed, Cardiovascular Systems, Chiesi, and Zoll.: 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; 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; E. Mahmud: Abbott: Principal Investigator for a Research Study; Abiomed: Consulting; Cardiovascular Systems, Inc.: Principal Investigator for a Research Study; Medtronic: Consulting; CSI: Principal Investigator for a Research Study; Microport: Principal Investigator for a Research Study; W. J. Nicholson: Dr. Nicholson has served as proctor, consultant, and advisory board member for Abbott Vascular, Boston Scientific and Medtronic.: Consulting; W. A. Jaber: consultant for Inari: Consulting; S. Rinfret: Prof Rinfret has been a consultant for Boston Scientific, Teleflex, Medtronic, Abbott, and Abiomed.: Consulting; A. Elguindy: Honoraria: Medtronic, Boston Scientific, Asahi Intecc, Abbott Proctorship fees: Medtronic, Boston Scientific, Asahi Intecc, Terumo Educational grants: Medtronic: 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; S. Kostantinis Nothing to disclose. B. Simsek Nothing to disclose. J. Karacsonyi Nothing to disclose. M. S. Megaly Nothing to disclose. O. Krestyaninov Nothing to disclose. D. Khelimskii Nothing to disclose. P. Poommipanit Nothing to disclose. M. Koutouzis Nothing to disclose. I. Tsiafoutis Nothing to disclose. J. W. Choi Nothing to disclose. P. Dattilo Nothing to disclose. Ş. Görgülü Nothing to disclose. B. Elbarouni Nothing to disclose. N. Abi Rafeh Nothing to disclose. Ö. Göktekin Nothing to disclose. O. C. Mastrodemos Nothing to disclose. B. V. Rangan Nothing to disclose. K. Alaswad: consultant and speaker for Boston Scientific, Abbott Cardiovascular, Teleflex, and CSI: Consulting; M. B. Basir: consultant for Abbott Vascular, Abiomed, Cardiovascular Systems, Chiesi, and Zoll.: 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; 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; E. Mahmud: Abbott: Principal Investigator for a Research Study; Abiomed: Consulting; Cardiovascular Systems, Inc.: Principal Investigator for a Research Study; Medtronic: Consulting; CSI: Principal Investigator for a Research Study; Microport: Principal Investigator for a Research Study; W. J. Nicholson: Dr. Nicholson has served as proctor, consultant, and advisory board member for Abbott Vascular, Boston Scientific and Medtronic.: Consulting; W. A. Jaber: consultant for Inari: Consulting; S. Rinfret: Prof Rinfret has been a consultant for Boston Scientific, Teleflex, Medtronic, Abbott, and Abiomed.: Consulting; A. Elguindy: Honoraria: Medtronic, Boston Scientific, Asahi Intecc, Abbott Proctorship fees: Medtronic, Boston Scientific, Asahi Intecc, Terumo Educational grants: Medtronic: 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; S. Kostantinis Nothing to disclose. B. Simsek Nothing to disclose. J. Karacsonyi Nothing to disclose. M. S. Megaly Nothing to disclose. O. Krestyaninov Nothing to disclose. D. Khelimskii Nothing to disclose. P. Poommipanit Nothing to disclose. M. Koutouzis Nothing to disclose. I. Tsiafoutis Nothing to disclose. J. W. Choi Nothing to disclose. P. Dattilo Nothing to disclose. Ş. Görgülü Nothing to disclose. B. Elbarouni Nothing to disclose. N. Abi Rafeh Nothing to disclose. Ö. Göktekin Nothing to disclose. O. C. Mastrodemos Nothing to disclose. B. V. Rangan Nothing to disclose.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.005 | 0.007 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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 source (direct Gemma or distilled Codex), 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".