Impacto de la adherencia a un algoritmo híbrido para la selección de la estrategia inicial de cruce en la intervención coronaria percutánea de oclusiones crónicas

Translated title of the contribution: Impact of adherence to the hybrid algorithm for initial crossing strategy selection in chronic total occlusion percutaneous coronary intervention

Iosif Xenogiannis, Khaldoon Alaswad, Oleg Krestyaninov, Dmitrii Khelimskii, Jaikirshan J. Khatri, James W. Choi, Farouc A. Jaffer, Mitul Patel, Ehtisham Mahmud, Anthony H. Doing, Phil Dattilo, Michalis Koutouzis, Ioannis Tsiafoutis, Barry Uretsky, Brian K. Jefferson, Taral Patel, Wissam Jaber, Habib Samady, Abdul M. Sheikh, Robert W. YehHector Tamez, Basem Elbarouni, Michael P. Love, Nidal Abi Rafeh, Assaad Maalouf, Abou Jaoudeh Fadi, Catalin Toma, Alpesh R. Shah, Raj H. Chandwaney, Mohamed Omer, Michael S. Megaly, Evangelia Vemmou, Ilias Nikolakopoulos, Bavana V. Rangan, Santiago Garcia, Shuaib Abdullah, Subhash Banerjee, M. Nicholas Burke, Dimitri Karmpaliotis, Emmanouil S. Brilakis

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction and objectives: The hybrid algorithm was designed to assist with initial and subsequent crossing strategy selection in chronic total occlusion (CTO) percutaneous coronary interventions (PCIs). However, the success of the initially selected strategy has received limited study. Methods: We examined the impact of adherence to the hybrid algorithm recommendation for initial CTO crossing technique selection in 4178 CTO PCIs from a large multicenter registry. Results: The initial crossing strategy was concordant with the hybrid algorithm recommendation in 1833 interventions (44%). Patients in the concordant group had a similar age to those in the discordant group but a lower mean J-CTO score (2.0 ± 1.4 vs 2.8 ± 1.1; P < .01). The concordant group showed higher technical success with the first crossing strategy (68% vs 48%; P < .01) and higher overall technical success (88% vs 83%; P < .01) with no difference in the incidence of in-hospital major adverse events (1.8% vs 2.3%; P =. 26). In multivariable analysis, after adjustment for age, prior myocardial infarction, prior PCI, prior coronary artery bypass grafting, J-CTO score, and scheduled CTO PCI, nonadherence to the hybrid algorithm was independently associated with lower technical success of the initial crossing strategy (odds ratio, 0.55; 95% confidence interval, 0.48-0.64; P < .01). Conclusions: Adherence to the hybrid algorithm for initial crossing strategy selection is associated with higher CTO PCI success but similar in-hospital major adverse cardiac events.

Translated title of the contributionImpact of adherence to the hybrid algorithm for initial crossing strategy selection in chronic total occlusion percutaneous coronary intervention
Original languageSpanish
JournalRevista Espanola de Cardiologia
DOIs
StateAccepted/In press - 2021

Keywords

  • Chronic total occlusion
  • Hybrid algorithm
  • Percutaneous coronary intervention
  • Retrograde approach

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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