Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/32693
Title: The evolution of the CTO-PCI landscape in Belgium and Luxembourg: a four-year appraisal
Authors: EERTMANS, Ward 
Kayaert, Peter
Bennett, Johan
Ungureanu, Claudiu
BATAILLE, Yoann 
Saad, Georges
Haine, Steven
Coussement, Patrick
Pereira, Bruno
Agostoni, Pierfrancesco
Janssens, Luc
Vandeloo, Bert
Marechal, Patrick
Cornelis, Kristoff
de Hemptinne, Quentin
Aminian, Adel
Stammen, Francis
Carlier, Stephane
Timmermans, Patrick
Vercauteren, Steven
Sonck, Jeroen
De Vroey, Frederic
Drieghe, Benny
McCutcheon, Keir
Scott, Benjamin
Davin, Laurent
Gafari, Chadi
DENS, Jo 
Issue Date: 2021
Publisher: TAYLOR & FRANCIS LTD
Source: ACTA CARDIOLOGICA, 76(10), p. 1043-1051
Abstract: Background To chart the evolution of the CTO-PCI landscape in Belgium and Luxembourg, the Belgian Working Group on Chronic Total Occlusions (BWGCTO) was established in 2016. Methods Between May 2016 and December 2019, patients undergoing a CTO-PCI treatment were prospectively and consecutively enrolled. Twenty-one centres in Belgium and one in Luxembourg participated. Individual operators had mixed levels of expertise in treating CTO lesions. Demographic, angiographic, procedural parameters and incidence of major adverse cardiac and cerebrovascular events (MACCE) were systematically registered. Results Over a four-year enrolment period, 1832 procedures were performed in 1733 patients achieving technical success in 1474 cases (80%), with an in-hospital MACCE rate of 2.3%. Fifty-nine (3%) cases were re-attempt procedures of which 41 (69%) were successful. High-volume centres treated more complex lesions (mean J-CTO score: 2.15 +/- 1.21) as compared to intermediate (mean J-CTO score: 1.72 +/- 1.23;p < 0.001) and low-volume centres (mean J-CTO score: 0.99 +/- 1.21;p = 0.002). Despite this, success rates did not differ between centres (p = 0.461). Overall success rates did not differ over time (p = 0.810). High-volume centres progressively tackled more complex CTOs while keeping success rates stable. In all centres, the most applied strategy was antegrade wire escalation (83%). High-volume centres more often successfully applied antegrade dissection and re-entry and retrograde techniques in lesions with higher complexity. Conclusion With variable experience levels, operators treated CTOs with high success and relatively few complications. Although AWE remains the most used technique, it is paramount for operators to be skilled in all contemporary techniques in order to be successful in more complex CTOs.
Notes: Eertmans, W (corresponding author), Ziekenhuis Oost Limburg, Dept Cardiol, Schiepse Bos 6, B-3600 Genk, Belgium.
ward.eertmans@zol.be
Other: Eertmans, W (corresponding author), Ziekenhuis Oost Limburg, Dept Cardiol, Schiepse Bos 6, B-3600 Genk, Belgium. ward.eertmans@zol.be
Keywords: Coronary total occlusion;percutaneous coronary intervention;in-hospital outcomes
Document URI: http://hdl.handle.net/1942/32693
ISSN: 0001-5385
e-ISSN: 1784-973X
DOI: 10.1080/00015385.2020.1801197
ISI #: WOS:000555650800001
Rights: 2020 Informa UK Limited.
Category: A1
Type: Journal Contribution
Validations: ecoom 2021
Appears in Collections:Research publications

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