Publications by authors named "Brian K Jefferson"
Article Synopsis
- The study analyzed over 11,500 chronic total occlusion percutaneous coronary intervention (CTO-PCI) procedures across North America and other regions from 2017 to 2023.
- North American CTO patients were generally older and had more health issues, such as diabetes and hypertension, as well as more complex lesions compared to non-North American patients.
- Despite differences in procedure techniques and patient complexity, the overall success rates and rates of major adverse cardiovascular events were similar between North American and non-North American centers.
Ranolazine is an anti-anginal medication given to patients with chronic angina and persistent symptoms despite medical therapy. We examined 11 491 chronic total occlusion (CTO) percutaneous coronary interventions (PCI) that were performed at 41 US and non-US centers between 2012 and 2023 in the PROGRESS-CTO Registry. Patients on ranolazine at baseline had more comorbidities, more complex lesions, lower procedural and technical success (based on univariable but not multivariable analysis), and higher incidence of major adverse cardiac events (MACE) (on both univariable and multivariable analysis).
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- Drug-coated balloons, specifically paclitaxel-coated balloons, show promise for treating coronary in-stent restenosis but previously lacked approval for U.S. use.
- A clinical trial, involving 600 participants across 40 centers, compared the effectiveness of paclitaxel-coated balloons to uncoated ones in preventing target lesion failure one year post-treatment.
- Results indicated that patients receiving the paclitaxel-coated balloon had significantly lower rates of target lesion revascularization and myocardial infarction compared to those with uncoated balloons, demonstrating the coated balloon's superiority (17.9% vs 28.6% failure rate).
Background: There is limited data on equipment loss or entrapment during chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Methods: We analyzed the baseline clinical and angiographic characteristics and outcomes of equipment loss/entrapment at 43 US and non-US centers between 2017 and 2023.
Results: Equipment loss/entrapment was reported in 40 (0.
Background: There is limited information on the impact of the target vessel on the procedural techniques and outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Methods: We analyzed the baseline clinical and angiographic characteristics and procedural outcomes of 11,580 CTO PCIs performed between 2012 and 2022 at 44 centers.
Results: The most common CTO target vessel was the right coronary artery (RCA) (53.
Article Synopsis
- Fever often indicates infection and needs thorough diagnostic evaluation in ICU patients.
- An updated guideline was created by IDSA and SCCM for diagnosing fever in adult ICU patients, using the GRADE method.
- A panel of 12 experts reviewed evidence and made 12 recommendations, including the use of central temperature monitoring for accurate assessments.
Background: Death is a rare but devastating complication of chronic total occlusion (CTO) percutaneous coronary intervention.
Methods: We examined the clinical characteristics and procedural outcomes of patients who died periprocedurally in the Prospective Global Registry for the Study of CTO Interventions (PROGRESS-CTO).
Results: Of the 12 928 patients who underwent CTO percutaneous coronary intervention between 2012 and 2022, 52 (0.
Background: Same day discharge (SDD) following chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study.
Methods: We evaluated the clinical, angiographic, and procedural characteristics of patients discharged the same day versus those kept for overnight observation in the Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS-CTO, NCT02061436).
Results: Of the 7181 patients who underwent CTO PCI, 943 (13%) had SDD.
Article Synopsis
- Bivalirudin is rarely used in chronic total occlusion (CTO) percutaneous coronary interventions (PCI), with only 0.75% of procedures utilizing it in a study from 2012 to 2022.
- There were no significant differences in primary outcomes like net adverse cardiac events (NACE), major adverse cardiac events (MACE), or vascular complications between the bivalirudin and unfractionated heparin groups.
- Further research is necessary to evaluate the safety and efficacy of bivalirudin for CTO-PCIs, given its limited use and comparable outcomes to traditional heparin.
Background: Guidewires and microcatheters are critical to the success of chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Methods: We examined equipment utilization in 11,202 CTO-PCIs performed in 10,952 patients at 42 United States (US) and non-US centers between 2012 and 2022.
Results: Antegrade-only crossing was attempted in 7628 CTO-PCIs (68%) and the retrograde approach was used in 3574 CTO-PCIs (32%).
Article Synopsis
- Approximately 6.3% of patients who underwent chronic total occlusion percutaneous coronary intervention (CTO-PCI) between 2012 and 2022 presented with acute coronary syndrome (ACS).
- ACS patients tended to be older and had a higher prevalence of comorbid conditions, but technical success rates and major adverse cardiovascular events (MACE) were similar to those without ACS.
- The study suggests that performing CTO-PCI on ACS patients yields comparable outcomes to non-ACS patients.
Background: Preprocedural coronary computed tomography angiography (CCTA) can be useful in procedural planning for chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Methods: We examined the clinical, angiographic and procedural characteristics and outcomes of cases with vs. without preprocedural CCTA in PROGRESS-CTO (NCT02061436).
Article Synopsis
- The study investigates balloon undilatable lesions in chronic total occlusion (CTO) percutaneous coronary intervention (PCI), an area that has not been thoroughly researched.
- About 8.5% of CTO lesions are identified as balloon undilatable, with affected patients being older and having more comorbidities compared to other patients undergoing PCI.
- Treatment for these lesions shows lower technical success rates and a higher risk of major adverse cardiovascular events (MACE) during hospitalization.*
Background: The relationship between left ventricular ejection fraction (LVEF) and the success and safety of coronary chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study.
Methods: We examined the clinical characteristics and outcomes of CTO PCI in the Prospective Global Registry for the Study of CTO Intervention (PROGRESS-CTO) after stratifying patients by LVEF (≤35%, 36%-49%, and ≥50%).
Results: A total of 7827 CTO PCI procedures with LVEF data were included.
Background: The outcomes of distal radial access (dRA) in chronic total occlusion percutaneous coronary intervention (CTO-PCI) have received limited study.
Methods: We compared the clinical, angiographic, and procedural characteristics of 120 CTO-PCIs performed via dRA access with 2625 CTO-PCIs performed via proximal radial access (pRA) in a large, multicenter registry.
Results: The dRA group had lower mean PROGRESS-CTO score than the pRA group (1.
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.
Background: The impact of intravascular ultrasound (IVUS) utilization for stent optimization on the long-term outcomes in chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study.
Methods: We examined the outcomes of CTO-PCI with and without IVUS use for stent optimization in 922 CTO-PCIs performed between 2012 and 2019 at 12 United States centers. Major adverse cardiac event (MACE) was defined as the composite of cardiac death, acute coronary syndrome, and target-vessel revascularization.
Background: The impact of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) on angina and subsequent incidence of major adverse cardiovascular event (MACE) rate remains controversial.
Methods: We compared patient- reported angina change and the incidence of MACE (defined as death, myocardial infarction [MI], target-vessel revascularization) between successful vs failed CTO-PCI in 1612 patients participating in a large, multicenter registry.
Results: CTO-PCI was successful in 1387 patients (86%).
Background: Catheter-based renal denervation has significantly reduced blood pressure in previous studies. Following a positive pilot trial, the SPYRAL HTN-OFF MED (SPYRAL Pivotal) trial was designed to assess the efficacy of renal denervation in the absence of antihypertensive medications.
Methods: In this international, prospective, single-blinded, sham-controlled trial, done at 44 study sites in Australia, Austria, Canada, Germany, Greece, Ireland, Japan, the UK, and the USA, hypertensive patients with office systolic blood pressure of 150 mm Hg to less than 180 mm Hg were randomly assigned 1:1 to either a renal denervation or sham procedure.
Objectives: The aim of this study was to examine the use of saphenous vein grafts (SVGs) for retrograde crossing during chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Background: The use of SVGs for retrograde crossing during CTO PCI has received limited study.
Methods: A total of 1,615 retrograde CTO PCIs performed between 2012 and 2019 at 25 centers were examined.
The impact of peripheral artery disease (PAD) in patients undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. We reviewed 3999 CTO PCIs performed in 3914 patients between 2012 and 2018 at 25 centers, 14% of whom had a history of PAD. We compared the clinical and angiographic characteristics and procedural outcomes of patients with versus without history of PAD.
View Article and Find Full Text PDFBackground: When crossing into the distal true lumen fails during chronic total occlusion (CTO) percutaneous coronary intervention (PCI), subintimal plaque modification (SPM) is often performed to restore antegrade flow and facilitate subsequent lesion recanalization.
Methods: Between January 2012 and May 4, 2019, 4,659 CTO PCIs were included in the PROGRESS-CTO registry, of which 935 (20%) had a prior unsuccessful attempt. Of those 935 patients, 119 (13%) had prior SPM.