E-28 | International Percutaneous Coronary Intervention Complication Survey
Bibliographic record
Abstract
BackgroundThe perceptions and management strategies of interventional cardiologists (ICs) of percutaneous coronary intervention (PCI) complications have received limited study.MethodsOnline survey on PCI complications: 46 questions were distributed via email lists and Twitter to ICs.ResultsOf 821 participants, 60% were from the United States with a median age group of 46-50 years. Annual PCI case numbers were <100 (26%), 100-199 (37%), 200-299 (21%), and ≥300 (16%); 42% do not perform structural interventions, others reported performing <40 (30%), >100 (11%) structural cases annually. On a scale of 0-10, participating ICs were highly concerned about potential complications with a median score of 6.7 (IQR: 5.1-8.7). The types of complications reported by ICs during the past year are shown in the Figure. The most feared complication was death (39%), followed by coronary perforation (26%) and stroke (9%). Covered stents were never deployed by 21%, and 32% deployed at least one during the past year; 79% have never used fat to seal perforations, and 5% used it during the past year; 64% have never used coils for perforations, and 10% used them during the past year. Complications were attributed to higher patient/angiographic complexity by 69% and seen as opportunities for improvement by 69%; 97% of participants were interested in learning more about the management of PCI complications. The most useful learning Methods were meetings (66%), webinars (48%), YouTube (32%), and Twitter (29%).ConclusionsDisclosuresL. Azzalini: Honoraria from Abbott Vascular, Guerbet, Terumo, and Sahajanand Medical Technologies and research support from ACIST Medical Systems, Guerbet, and Terumo.: Consulting; A. B. Hall: A. Hall reports speaker fees/honoraria from Medtronic, OpSens Medical and Cardiovascular Innovations Foundation.: Consulting; K. J. Croce: Abbott: Advisory Board/Board Member and Consulting; Abiomed: Advisory Board/Board Member and Consulting; Boston Scientific Corp.: Advisory Board/Board Member and Consulting; Cardiovascular Systems, Inc.: Advisory Board/Board Member and Consulting; Philips: Advisory Board/Board Member and Consulting; dyad: Ownership Interests: Stocks, Stock Options; takeda: Consulting; biotronik: Consulting; S. Banerjee: Medtronic: Consulting; Cordis: Consulting; Kaneka: Consulting; Boston Scientific Corp.: Principal Investigator for a Research Study; Chiesi: Principal Investigator for a Research Study; M. H. Shishehbor: Abbott: Advisory Board/Board Member and Consulting; Boston Scientific Corp.: Advisory Board/Board Member and Consulting; Medtronic: Advisory Board/Board Member and Consulting; Philips: Advisory Board/Board Member and Consulting; P. Sorajja: Abbott: Advisory Board/Board Member and Consulting; W. L. Lombardi: Boston Scientific Corp.: Advisory Board/Board Member and Consulting; Abiomed: Consulting; Medtronic: Consulting; wife employee: Employed or Salary; Rampart IC: Ownership Interests: Stocks, Stock Options; Asahi intecc: Consulting and Royalties; 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; B. Simsek Nothing to disclose. S. Kostantinis Nothing to disclose. J. Karacsonyi Nothing to disclose. Y. B. Sandoval Nothing to disclose. M. McEntegart Nothing to disclose. O. C. Mastrodemos Nothing to disclose. B. V. Rangan Nothing to disclose. BackgroundThe perceptions and management strategies of interventional cardiologists (ICs) of percutaneous coronary intervention (PCI) complications have received limited study. The perceptions and management strategies of interventional cardiologists (ICs) of percutaneous coronary intervention (PCI) complications have received limited study. MethodsOnline survey on PCI complications: 46 questions were distributed via email lists and Twitter to ICs. Online survey on PCI complications: 46 questions were distributed via email lists and Twitter to ICs. ResultsOf 821 participants, 60% were from the United States with a median age group of 46-50 years. Annual PCI case numbers were <100 (26%), 100-199 (37%), 200-299 (21%), and ≥300 (16%); 42% do not perform structural interventions, others reported performing <40 (30%), >100 (11%) structural cases annually. On a scale of 0-10, participating ICs were highly concerned about potential complications with a median score of 6.7 (IQR: 5.1-8.7). The types of complications reported by ICs during the past year are shown in the Figure. The most feared complication was death (39%), followed by coronary perforation (26%) and stroke (9%). Covered stents were never deployed by 21%, and 32% deployed at least one during the past year; 79% have never used fat to seal perforations, and 5% used it during the past year; 64% have never used coils for perforations, and 10% used them during the past year. Complications were attributed to higher patient/angiographic complexity by 69% and seen as opportunities for improvement by 69%; 97% of participants were interested in learning more about the management of PCI complications. The most useful learning Methods were meetings (66%), webinars (48%), YouTube (32%), and Twitter (29%). Of 821 participants, 60% were from the United States with a median age group of 46-50 years. Annual PCI case numbers were <100 (26%), 100-199 (37%), 200-299 (21%), and ≥300 (16%); 42% do not perform structural interventions, others reported performing <40 (30%), >100 (11%) structural cases annually. On a scale of 0-10, participating ICs were highly concerned about potential complications with a median score of 6.7 (IQR: 5.1-8.7). The types of complications reported by ICs during the past year are shown in the Figure. The most feared complication was death (39%), followed by coronary perforation (26%) and stroke (9%). Covered stents were never deployed by 21%, and 32% deployed at least one during the past year; 79% have never used fat to seal perforations, and 5% used it during the past year; 64% have never used coils for perforations, and 10% used them during the past year. Complications were attributed to higher patient/angiographic complexity by 69% and seen as opportunities for improvement by 69%; 97% of participants were interested in learning more about the management of PCI complications. The most useful learning Methods were meetings (66%), webinars (48%), YouTube (32%), and Twitter (29%). Conclusions DisclosuresL. Azzalini: Honoraria from Abbott Vascular, Guerbet, Terumo, and Sahajanand Medical Technologies and research support from ACIST Medical Systems, Guerbet, and Terumo.: Consulting; A. B. Hall: A. Hall reports speaker fees/honoraria from Medtronic, OpSens Medical and Cardiovascular Innovations Foundation.: Consulting; K. J. Croce: Abbott: Advisory Board/Board Member and Consulting; Abiomed: Advisory Board/Board Member and Consulting; Boston Scientific Corp.: Advisory Board/Board Member and Consulting; Cardiovascular Systems, Inc.: Advisory Board/Board Member and Consulting; Philips: Advisory Board/Board Member and Consulting; dyad: Ownership Interests: Stocks, Stock Options; takeda: Consulting; biotronik: Consulting; S. Banerjee: Medtronic: Consulting; Cordis: Consulting; Kaneka: Consulting; Boston Scientific Corp.: Principal Investigator for a Research Study; Chiesi: Principal Investigator for a Research Study; M. H. Shishehbor: Abbott: Advisory Board/Board Member and Consulting; Boston Scientific Corp.: Advisory Board/Board Member and Consulting; Medtronic: Advisory Board/Board Member and Consulting; Philips: Advisory Board/Board Member and Consulting; P. Sorajja: Abbott: Advisory Board/Board Member and Consulting; W. L. Lombardi: Boston Scientific Corp.: Advisory Board/Board Member and Consulting; Abiomed: Consulting; Medtronic: Consulting; wife employee: Employed or Salary; Rampart IC: Ownership Interests: Stocks, Stock Options; Asahi intecc: Consulting and Royalties; 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; B. Simsek Nothing to disclose. S. Kostantinis Nothing to disclose. J. Karacsonyi Nothing to disclose. Y. B. Sandoval Nothing to disclose. M. McEntegart Nothing to disclose. O. C. Mastrodemos Nothing to disclose. B. V. Rangan Nothing to disclose. L. Azzalini: Honoraria from Abbott Vascular, Guerbet, Terumo, and Sahajanand Medical Technologies and research support from ACIST Medical Systems, Guerbet, and Terumo.: Consulting; A. B. Hall: A. Hall reports speaker fees/honoraria from Medtronic, OpSens Medical and Cardiovascular Innovations Foundation.: Consulting; K. J. Croce: Abbott: Advisory Board/Board Member and Consulting; Abiomed: Advisory Board/Board Member and Consulting; Boston Scientific Corp.: Advisory Board/Board Member and Consulting; Cardiovascular Systems, Inc.: Advisory Board/Board Member and Consulting; Philips: Advisory Board/Board Member and Consulting; dyad: Ownership Interests: Stocks, Stock Options; takeda: Consulting; biotronik: Consulting; S. Banerjee: Medtronic: Consulting; Cordis: Consulting; Kaneka: Consulting; Boston Scientific Corp.: Principal Investigator for a Research Study; Chiesi: Principal Investigator for a Research Study; M. H. Shishehbor: Abbott: Advisory Board/Board Member and Consulting; Boston Scientific Corp.: Advisory Board/Board Member and Consulting; Medtronic: Advisory Board/Board Member and Consulting; Philips: Advisory Board/Board Member and Consulting; P. Sorajja: Abbott: Advisory Board/Board Member and Consulting; W. L. Lombardi: Boston Scientific Corp.: Advisory Board/Board Member and Consulting; Abiomed: Consulting; Medtronic: Consulting; wife employee: Employed or Salary; Rampart IC: Ownership Interests: Stocks, Stock Options; Asahi intecc: Consulting and Royalties; 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; B. Simsek Nothing to disclose. S. Kostantinis Nothing to disclose. J. Karacsonyi Nothing to disclose. Y. B. Sandoval Nothing to disclose. M. McEntegart 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 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.021 | 0.007 |
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".