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December 31, 2015Catheterization and Cardiovascular Interventions

Comparison of percutaneous coronary intervention for chronic total occlusion outcome according to operator experience from the J apanese retrograde summit registry

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Key result

Percutaneous coronary intervention for chronic total occlusion at higher volume centers had a significantly higher procedural success rate than at lower volume centers (90.6% vs. 85.6%, P<0.0001).

Why the study?

Does higher operator experience (higher volume centers) improve procedural success rates in patients undergoing PCI for chronic total occlusion?

Population

3,229 subjects undergoing percutaneous coronary intervention for chronic total occlusion across 56 centers…

Comparison

PCI performed at higher volume centers with more… vs PCI performed at lower volume centers with less…

Design

Cohort

Follow-up

in-hospital

Authors

MHMaoto HabaraToyohashi Heart CenterETEtsuo TsuchikaneInterventional CardiologyTMToshiya MuramatsuTokyo Medical and Dental University

Discussion

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Implication

Supports volume-outcome link in CTO-PCI; leaves open whether selective referral improves outcomes in prospective trials.

Study Design

Type

Observational (n=3,229)

Multicenter

Yes

Structured PICO

Does higher operator experience (higher volume centers) improve procedural success rates in patients undergoing PCI for chronic total occlusion?

P
Population
3,229 subjects who underwent percutaneous coronary intervention for chronic total occlusion across 56 centers.
E
Exposure
PCI performed at higher volume centers (HC, 18 centers) with more operator experience.
C
Comparator
PCI performed at lower volume centers (LC, 38 centers) with less operator experience.
O
Outcome
Procedural success rate

Main Result

Absolute Event Rate: 90.6% vs 85.6%

p-value: p=< 0.0001

Higher operator volume is associated with improved procedural success rates in CTO-PCI, primarily due to higher antegrade success, without compromising safety.

Cite This Study

Habara et al. (2015) conducted an observational in Chronic total occlusion (CTO) (n=3,229). Higher volume centers (HC) vs. Lower volume centers (LC) was evaluated on Overall procedural success rate (p=< 0.0001). Percutaneous coronary intervention for chronic total occlusion at higher volume centers had a significantly higher procedural success rate than at lower volume centers (90.6% vs. 85.6%, P<0.0001).

synapsesocial.com/papers/6a937f790d31bab2d3e1ba3fhttps://doi.org/10.1002/ccd.26354

Topics

Percutaneous coronary interventionChronic total occlusion PCI
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Percutaneous Coronary Intervention versus Coronary-Artery Bypass Grafting for Severe Coronary Artery Disease2009 · 4,383 citations
  2. 2Japanese multicenter registry evaluating the retrograde approach for chronic coronary total occlusion2013 · 103 citations
  3. 3In-hospital outcomes of percutaneous coronary intervention in patients with chronic total occlusion: insights from the ERCTO (European Registry of Chronic Total Occlusion) registry2011 · 342 citations
  4. 4Contemporary retrograde approach for the recanalisation of coronary chronic total occlusion: on behalf of the Japanese Retrograde Summit Group2013 · 83 citations
  5. 5Coronary septal collaterals as an access for the retrograde approach in the percutaneous treatment of coronary chronic total occlusions2007 · 162 citations