Publications by authors named "Khelimskiĭ D"
Background: Upfront 2-stent techniques are often used in bifurcation percutaneous coronary interventions (PCI), but there is controversy about optimal strategy selection.
Methods: The authors examined the clinical and angiographic characteristics and long-term outcomes of 232 bifurcation PCIs that were performed using the double kissing (DK) crush or culotte technique in 216 patients between 2014 and 2023 using data from the Prospective Global Registry for the Study of Bifurcation Lesion Interventions (NCT05100992). The inverse probability of treatment weighted (IPTW) Cox proportional hazards model was used to assess long-term outcomes.
The outcomes of bifurcation percutaneous coronary intervention (PCI) in patients aged ≥80 and ≥90 years have received limited study. We compared the procedural characteristics and outcomes of bifurcation PCIs in patients aged ≥80 years and those aged <80 years in a multicenter registry. Of 1,253 patients who underwent 1,262 bifurcation PCIs between 2014 and 2024 at 6 centers, 194 (15%) were aged ≥80 and ≥90 years.
View Article and Find Full Text PDFBackground: Proximal vessel tortuosity can hinder wiring and equipment delivery during chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Aims: We sought to examine the association of proximal vessel tortuosity with the short and long-term outcomes of patients undergoing CTO PCI.
Methods: We examined the association of proximal vessel tortuosity with clinical outcomes in patients who underwent CTO PCI at 50 US and non-US centers between 2012 and 2024.
Background: The J-CTO investigators recently developed angiographic difficulty scores for each of the three major coronary arteries in patients undergoing first-attempt chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in de novo occlusions.
Methods: We examined the performance of the individual J-CTO scores in a large multicenter registry.
Results: The CTO lesion location was as follows: right coronary artery (RCA) 3,805 (54%), left anterior descending artery (LAD) 2,303 (33%), and left circumflex (LCX) 935 (13%).
The impact of diabetes mellitus (DM) on the outcomes of bifurcation percutaneous coronary intervention (PCI) has received limited study. We compared the procedural characteristics and outcomes of patients with and without DM in 1,302 bifurcation PCIs (1,147 patients) performed at 5 centers between 2013 and 2024. The prevalence of DM was 33.
View Article and Find Full Text PDFThere are limited comparative data on the use of plaque modification devices during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We compared intravascular lithotripsy (IVL) with rotational atherectomy (RA) for lesion preparation in patients who underwent CTO PCI across 50 US and non-US centers from 2019 to 2024. Of 15,690 patients who underwent CTO PCI during the study period, 436 (2.
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- A study analyzed the outcomes of chronic total occlusion (CTO) percutaneous coronary interventions (PCI) specifically in patients with anomalous coronary arteries (ACA) from a large dataset of over 14,000 patients between 2012 and 2023.
- Among 14,470 CTO procedures, only 36 (0.24%) were performed on patients with ACA, who displayed similar baseline characteristics to those without ACA, but had more complicated lesions, requiring longer procedures and greater contrast volume.
- Despite the increased complexity, ACA patients achieved similar procedural success rates to non-ACA patients, with no major adverse cardiac events reported in the ACA group, indicating a favorable outcome for CTO PCI in
Artificial Intelligence (AI) permeates all areas of our lives. Even now, we all use AI algorithms in our daily activities, and medicine is no exception. The potential of AI technology is hard to overestimate; AI has already proven its effectiveness in many fields of science and technology.
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- A study was conducted to create and validate a machine learning model to predict the success of chronic total occlusion crossing through primary antegrade wiring, using a large dataset from 12,136 cases in the PROGRESS CTO registry.
- The extreme gradient boosting model showed the best performance with an area under the receiver-operating characteristic curve of around 0.78, indicating its effectiveness.
- Key factors influencing the success included occlusion length and vessel characteristics, while aorto-ostial lesion location had minimal impact; a web application for predicting outcomes is available online.
Article Synopsis
- The study examined the effects of prolonged dual antiplatelet therapy (DAPT) on patients with bifurcation coronary lesions who underwent percutaneous coronary interventions (PCI).
- A total of 1000 patients were analyzed, with 394 receiving DAPT for over 12 months, but there were no significant differences in major adverse cardiovascular events (MACE) between those with prolonged DAPT and those with shorter therapy (18.8% vs. 14.9%).
- Patients with high ischemic risk had a higher likelihood of MACE, but extending DAPT beyond 12 months did not improve outcomes compared to a shorter duration.
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).
View Article and Find Full Text PDFBackground: The complex high-risk indicated percutaneous coronary intervention (CHIP) score is a tool developed using the British Cardiovascular Intervention Society (BCIS) database to define CHIP cases and predict in-hospital major adverse cardiac or cerebrovascular events (MACCE).
Aim: To assess the validity of the CHIP score in chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Methods: We evaluated the performance of the CHIP score on 8341 CTO PCIs from the Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS-CTO) performed at 44 centers between 2012 and 2023.
Article Synopsis
- Plaque modification microcatheters (PM), specifically Tornus and Turnpike Gold, are specialized devices used to treat chronic total occlusion (CTO) in coronary artery interventions.
- In a study analyzing their use across multiple centers, PMs were employed in 242 cases, representing only 1.6% of total procedures, with usage declining over time.
- The results showed that both types of microcatheters had similar success rates and complication levels, indicating that while they are seldom used, they are effective and safe in CTO interventions.
Background: Antegrade wiring is the most commonly used chronic total occlusion (CTO) crossing technique.
Methods: Using data from the PROGRESS CTO registry (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention; Clinicaltrials.gov identifier: NCT02061436), we examined the clinical and angiographic characteristics and procedural outcomes of CTO percutaneous coronary interventions (PCIs) performed using a primary antegrade wiring strategy.
Objectives: There is limited data on race and outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). The authors sought to evaluate CTO PCI techniques and outcomes in different racial groups.
Methods: We examined the baseline characteristics and procedural outcomes of 11 806 CTO PCIs performed at 44 US and non-US centers between 2012 and March 2023.
There is significant variation in wire utilization patterns for chronic total occlusion (CTO) percutaneous coronary intervention. This study aimed to compare the outcomes of polymer-jacketed wires (PJWs) versus non-PJWs in anterograde procedures. We analyzed clinical and angiographic characteristics, and procedural outcomes of 7,575 anterograde CTO percutaneous coronary interventions that were performed at 47 centers between 2012 and 2023.
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- Ostial chronic total occlusions (CTOs) make up 12% of all CTOs and present more challenges in percutaneous coronary interventions (PCI), resulting in lower success rates compared to non-ostial CTOs.
- Patients with ostial CTOs show a higher risk of major adverse cardiac events (MACE), including in-hospital death and stroke.
- Interventions for ostial CTOs often require longer procedure times and increased radiation exposure, indicating their complexity and difficulty.
Article Synopsis
- Retrograde chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has lower success rates and higher complications compared to the antegrade method, yet its outcomes and techniques were evaluated in this study involving over 4,000 cases.
- The study found that retrograde crossing was successful in about 60.5% of cases, with technical success rates of 78.7% and a 3.5% rate of major adverse cardiac events (MACE) during hospitalization.
- Among various retrograde techniques, retrograde true lumen puncture showed the best safety profile, but overall there is room for improvement in both the efficacy and safety of retrograde CTO PCI procedures.*
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.
Vascular bypass surgery takes a significant place in the treatment of vascular disease. According to various assessments, this type of surgery is associated with almost 20 % of all vascular surgery episodes (up to 23 % according to the Federal Neurosurgical Center of Novosibirsk). Even though the problem of using of vascular grafts is obvious and natural, many problems associated with them are not still elucidated.
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- - The study analyzed data from over 12,000 patients across multiple centers to assess the use and outcomes of antegrade dissection and re-entry (ADR) techniques during chronic total occlusion (CTO) percutaneous coronary interventions (PCI) from 2012 to 2023.
- - ADR was used in 18.6% of cases studied, but its usage has significantly declined from 37.9% in 2012 to 14.5% in 2022, with procedures utilizing ADR linked to more complex cases, lower technical success (77% vs. 89%), and higher rates of serious cardiac events.
- - The study highlighted a shift in re-entry device preferences, with the CrossBoss