Publications by authors named "Nidal Abi-Rafeh"
Background: 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.
There 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
Article Synopsis
- 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.
Background: 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.
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
- A study assessed the relationship between activated clotting time (ACT) and in-hospital outcomes for patients undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
- Out of 4,377 patients, it was found that low (<200 seconds) and high (>400 seconds) ACT levels were linked to higher risks of net adverse cardiovascular events (NACE), compared to the ideal range of 200 to 400 seconds.
- The findings suggest that an optimal ACT range is crucial as low ACT increases ischemic events while high ACT leads to more bleeding complications during CTO PCI.
Background: Contemporary chronic total occlusion (CTO) percutaneous coronary intervention (PCI) practice has received limited study.
Aim: To examine the contemporary CTO PCI practice.
Methods: We performed an online, anonymous, international survey of CTO PCI operators.
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.
Background: We examined the effect of atrial fibrillation on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Methods: We examined the baseline characteristics and procedural outcomes of 9,166 CTO PCIs performed at 39 US and non-US centers between 2012 and 2023.
Results: Atrial fibrillation was present in 1122 (12%) patients.
Article Synopsis
- - 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
We examined the outcomes of the Carlino technique in chronic total occlusion (CTO) percutaneous coronary interventions (PCIs). We analyzed the baseline clinical and angiographic characteristics and outcomes of 128 CTO PCIs that included the Carlino technique at 22 US and no-US centers between 2016 and 2023. The Carlino technique was used in 128 (2.
View Article and Find Full Text PDFChronic total occlusion (CTO) percutaneous coronary intervention (PCI) has been rapidly evolving in different parts of the world. We examined the clinical and angiographic characteristics and procedural outcomes of 1,079 consecutive CTO PCIs performed in 1,063 patients at 10 centers in the Middle East, North Africa, Turkey, and Asia regions between 2018 and 2022. The mean age was 61 ± 10 years and 82% of the patients were men.
View Article and Find Full Text PDFBackground: The impact of preprocedural anemia on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study.
Methods: We examined the clinical and angiographic characteristics and procedural outcomes of 8633 CTO PCIs performed at 39 US and non-US centers between 2012 and 2023. Anemia was defined as a hemoglobin level of <13 g/dL in men and <12 g/dL in women.
Background: There is limited data on the use of the balloon-assisted subintimal entry (BASE) technique in chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Methods: We analyzed the baseline clinical and angiographic characteristics and outcomes of 155 CTO PCIs that utilized the BASE technique at 31 US and non-US centers between 2016 and 2023.
Results: The BASE technique was used in 155 (7.
The outcomes of chronic total occlusion (CTO) percutaneous coronary interventions (PCIs) in patients with previous coronary artery bypass graft (CABG) surgery have received limited study. We examined the baseline characteristics and outcomes of CTO PCIs performed at 47 United States and non-United States centers between 2012 and 2023. Of the 12,164 patients who underwent CTO PCI during the study period, 3,475 (29%) had previous CABG.
View Article and Find Full Text PDFBackground: Coronary calcification is common and increases the difficulty of chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Methods: We examined the impact of calcium on procedural outcomes of 13,079 CTO PCIs performed in 12,799 patients at 46 US and non-US centers between 2012 and 2023.
Results: Moderate or severe calcification was present in 46.
Background: Donor vessel injury is a potentially life-threatening complication of chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Aims: Our goal was to examine the incidence, mechanisms, treatment, and outcomes of patients with donor vessel injury in a large multicenter CTO PCI registry.
Methods: We analyzed the baseline clinical and angiographic characteristics, and procedural outcomes of 12,349 CTO PCIs performed between 2012 and 2022 at 44 centers.
Estimating the likelihood of urgent mechanical circulatory support (MCS) can facilitate procedural planning and clinical decision-making in chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We analyzed 2,784 CTO PCIs performed between 2012 and 2021 at 12 centers. The variable importance was estimated by a bootstrap applying a random forest algorithm to a propensity-matched sample (a ratio of 1:5 matching cases with controls on center).
View Article and Find Full Text PDFBackground: Distal vessel quality is a key parameter in the global chronic total occlusion (CTO) crossing algorithm.
Objectives: The study sought to evaluate the association of distal vessel quality with the outcomes of CTO percutaneous coronary intervention.
Methods: We examined the clinical and angiographic characteristics and procedural outcomes of 10,028 CTO percutaneous coronary interventions performed at 39 U.