D-37 | Guide Catheter Extension Use in Chronic Total Occlusion Percutaneous Coronary Intervention: Insights from the PROGRESS CTO Registry
Bibliographic record
Abstract
There is limited data on the use of guide catheter extensions (GCE) during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We examined the frequency and temporal trends of GCE use in a large multicenter CTO PCI registry. We compared the clinical and angiographic characteristics, and outcomes of cases with vs. without GCE use. A GCE was used in 4,106 of 14,521 CTO PCIs (28%) performed between 2012 to 2023. GCE use increased from 18.8% in 2012 to 29.9% in 2023 (P <0.0001). The most commonly used GCE size was 6Fr (45%), followed by 7Fr (34%), and 8Fr (21%). Patients that required GCE use had more comorbidities, such as diabetes (47% vs 42%, P <0.0001), prior coronary artery bypass surgery (40% vs 24%, P<0.0001), and prior PCI (40% vs 24%, P < 0.0001). GCE patients were more likely to have unfavorable lesion characteristics such as moderate to severe calcification (59% vs 40%, P < 0.0001), moderate to severe tortuosity (35% vs 28%, P<0.0001), and had higher J-CTO scores (2.78 ± 1.15 vs 2.20 ± 1.27, P<0.0001). Advanced techniques like the retrograde approach (44% vs 24%, P<0.0001) and antegrade dissection & re-entry (28% vs 17%, P <0.0001) were more likely to be used in GCE cases. Technical success (86.6% vs 86.8%, P = 0.816) was similar between the two groups. Major adverse cardiovascular events (MACE) (3.8% vs 2.4%, P<0.0001) and procedural complications (11.2% vs 8.7%, P<0.0001) were more frequent in the GCE group. GCE use in CTO PCI significantly increased between 2012 and 2023. Cases that required GCEs were more complex and had similar technical success, but higher incidence of MACE.
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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 | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.181 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".