Abstract 14721: International Chronic Total Occlusion Percutaneous Coronary Intervention Operator Survey
Bahadir Simsek, Athanasios Rempakos, Spyridon Kostantinis, Michaella Alexandrou, Judit A Karacsonyi, Bavana V Rangan, Olga Mastrodemos, Nidal Abi Rafeh, MD, FACC, Khaldoon Alaswad, ALEXANDRE AVRAN, Lorenzo Azzalini, Ahmed El Guindy, Mohaned Egred, OMER GOKTEKIN, sevket gorgulu, Wissam Jaber, Kathleen Kearney, Ajay J Kirtane, William L Lombardi, Kambis Mashayekhi, Margaret McEntegart, William Nicholson, Stephane Rinfret, Salman S Allana, Yader Sandoval, M Nicholas Burke, Emmanouil S Brilakis- Physiology (medical)
- Cardiology and Cardiovascular Medicine
Background: Contemporary chronic total occlusions (CTO) percutaneous coronary intervention (PCI) practice has received limited study.
Methods: We performed an online, anonymous, international survey of CTO PCI operators.
Results: 104 CTO PCI operators and 12 interventional cardiology fellows with an interest in CTO PCI participated in this survey. Most were from the United States (53%), men (95%), and spent a median of 60 hours/week in the hospital. Median annual case numbers were 250 (150-400) for PCIs and 43 (10-85) for CTO PCIs (Figure). Almost half (42%) entered CTO cases into registries, mainly into PROGRESS-CTO (78%) and EuroCTO (11%). Most worked at academic institutions (55%), 55% trained dedicated CTO fellows, and 43% proctored CTO PCI. Almost half (43%) had dedicated CTO PCI days, and 54% performed dual access >90% of the time. Nearly half (42%) never discharged CTO patients the same day, while 20% discharged CTO patients the same day >50% of the time. After successful guidewire crossing, 51% used intravascular imaging >90% of the time. Most used CTO scores including J-CTO (82%), PROGRESS-CTO (42%), and PROGRESS-CTO complication scores (24%). Coronary artery perforation was encountered within the last month by 31%, and within 1-6 months by 35%. On a scale of 0-10, the median comfort levels were: covered stents 9.7 (8.2-10), coil embolization 8.0 (5.0-9.7), and fat embolization 5.0 (2.0-9.4). The majority (55%) had a complication cart/kit and 22% conducted regular complication drills with catheterization laboratory staff.
Conclusion: Our survey provides information on the contemporary CTO PCI practices.