Date post: | 15-Apr-2017 |
Category: |
Health & Medicine |
Upload: | eurocto |
View: | 249 times |
Download: | 4 times |
Alfredo R. Galassi and Nicolaus ReifartThe Sicilian and the German (sicilian)
Update Euro CTO Registry
Euro CTO Club Membership
2006 2007 2008 2009 2010 2011 2012 20130
10
20
30
40
50
60
13
21
2933
3843
5255
2008 2009 2010 2011 2012 20130
500
1000
1500
2000
2500
3000
1303
1724
2189
2634 2603 2660
Online Registry 2008-2013
2006 2007 2008 2009 2010 2011 2012 20130
20
40
60
80
100
75 7780 82
85.3 85 85.3 87
Angiographic Success
%
2008 2009 2010 2011 2012 20130%
20%
40%
60%
80%
100%
90 88.5 89.5 8677 71
10 11.5 10.5 1423 29
Antegrade Retrograde± Antegrade
Antegrade /Retrograde Procedures
2008 2009 2010 2011 2012 20130%
20%
40%
60%
80%
100%
5031 28.6
20.5 18.8 14.6
5069 71.4
79.5 81.2 85.4
Antegrade only Retrograde + Antegrade
Antegrade /Retrograde Operators
N=48N=48N=44N=35N=29N=24
2008 2009 2010 2011 2012 20130
20
40
60
80
10085.5 86.5 88.1 87.6 87.8 90.3
73.664.2
77.1 76.5 77.8 79.5
Antegrade Retrograde
Angiographic Success
%
J-CTO score
Morino et al. J Am Coll Cardiol 2011
2008 2009 2010 2011 2012 201370
80
90
100
1
2
3
0
Ang
iogr
aphi
c su
cces
s (%
) J-CTO
score (median)
J-CTO score / Success
1.6 1.7 1.62
2.3 2.4
8082
86 85 85. 3 87
2008 2009 2010 2011 2012 20130%
20%
40%
60%
80%
100%
50
23 17 11 13 5
33
27
1725 16
22
17
40
49
34 3723
10 17
36 3142
4 8 8
<50 50-100 100-200 200-500 >500
Operators ExperienceN=48N=48N=44N=35N=29N=24
2008-2012 CTO interventions
8647 patients
9643 lesions
Drop out for missing data
47 patients
54 lesions
Included
8600 patients
9589 lesionsRetrograde (16.5%)
1395 patients
1582 lesions
Antegrade (83.5%)
7205 patients
8007 lesions
Procedural success (75%)
1060 patients
1191 lesions
Procedural failure (25%)
335 patients
391 lesions
Clinical follow-up
24.7 ± 15 months
931 patients (66.7%)
Retrograde CTO revascularization in Europe
Clinical Follow-up
MACCE Death MI Stroke Revasc.0
10
20
30
40
50
13.6
1.9 3.20.6
138.7
0.6 2.3 0.9
8.6
23.9
4.3 5.4
0
23.6
Overall Successful Unsuccessful
%
P<0.001
P=0.001 P=0.014 P=0.120
P<0.001
Gender (M)
COPD
Prior MI
Prior PCI
LVEF < 35%
J-CTO score
Failure p<0.001
p<0.001
p=0.005
p=0.018
p=0.221
p=0.074
p=0.001
Predictors of MACCE Occurrence
Symptoms(Successful Procedures)
CCS pre CCS post NYHA pre NYHA post0%
20%
40%
60%
80%
100%
27.1
83.5
53.2
78.4
44
15.1
36.7
18.328.9
1.49.2 2.3
0 0 0.9 0.9
Class I Class II Class III Class IV
P<0.001 P<0.001
Credibility check of the online EuroCTO-registry 2008-14
• Logical checks on data ( predefined value ranges)
• Logical consistency-tests with respect to other data fields
• Automatic warnings when data are missing
At random : „ your patient was selected for monitoring“
Automatic export of registry parameters
9 parameters to be
checked by reviewer
Step 1 CD will automatically be uploaded (Videoloader)
Operator
It automatically stores all files to prepare
Step 2 select EuroCTO Club-owned page
Step 3 select the runs to be reviewed
Any run can be played at high resolution and be reviewed
4 Cineruns to be uploaded
1. CTO vessel with retrograde/antegrade distal filling;
2. Wire passage 3. If applicable also for retrograde access4. Final result showing residual lesion
and runoff.
1
2
34
5/ 67
8 9
Monitor:
• The monitor will evaluate the case in a structured way that finally results in an
• a) agreement, • b) agreement with slight differences or • c) relevant disagreement (i.e. no CTO or
no TIMI 3 flow)
Test: Operator NR Monitor GW
Calculated accordance 84 %
Summary: ERCTO-Monitoring
• Randomly selects 10% of cases• Non biased controll of data entry• Will indentify: errors of data entry,
interpretation or coding and errors of intention
• Will increase credibility and scientific value ( at no costs except our efforts)