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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/22820

Title: The Hybrid Algorithm for Treating Chronic Total Occlusions in Europe The RECHARGE Registry
Authors: Maeremans, Joren
Walsh, Simon
Knaapen, Paul
Spratt, James C.
Avran, Alexandre
Hanratty, Colm G.
Faurie, Benjamin
Agostoni, Pierfrancesco
Bressollette, Erwan
Kayaert, Peter
Bagnall, Alan J.
Egred, Mohaned
Smith, Dave
Chase, Alexander
McEntegart, Margaret B.
Smith, William H. T.
Harcombe, Alun
Kelly, Paul
Irving, John
Smith, Elliot J.
Strange, Julian W.
Dens, Joseph
Issue Date: 2016
Abstract: BACKGROUND The hybrid algorithm for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) was developed to improve procedural outcomes. Large, prospective studies validating the algorithm in a broad multicenter setting with operators of different experience levels are lacking. OBJECTIVES The RECHARGE (REgistry of Crossboss and Hybrid procedures in FrAnce, the NetheRlands, BelGium and UnitEd Kingdom) registry aims to report achievable results using the hybrid algorithm. METHODS Between January 2014 and October 2015, consecutive patients undergoing hybrid CTO-PCI were prospectively enrolled in 17 centers. Procedural techniques, outcomes, and in-hospital complications were analyzed. RESULTS A total of 1,253 CTO-PCIs were performed in 1,177 patients, of which 86% were men. Mean age was 66 +/- 11 years. The average Japanese CTO score was 2.0 +/- 1.0, and was higher in the failure group (2.6 +/- 0.6 vs. 1.9 +/- 1.0; p < 0.001). Overall procedure success was 86% and major in-hospital complications occurred in 2.6%. Antegrade wire escalation was the preferred primary strategy in 77%, followed by retrograde (17%) and antegrade dissection re-entry strategies (7%). Primary strategies were successful in 60%. Consecutive strategies were applied in 34% and were successful in 74%. Antegrade dissection re-entry and retrograde strategies were the most common bailout strategies and were successful in 67% and 62%, respectively. Median procedure and fluoroscopy time were 90 (interquartile range [ IQR]: 60 to 120) min and 35 (IQR: 21 to 55) min, contrast volume was 250 (IQR: 180 to 340) ml, and radiation doses (air kerma and dose area product) were 1.6 (IQR: 1.0 to 2.7) Gy and 98 (IQR: 57 to 168) Gy.cm(2), respectively. CONCLUSIONS High procedure and patient success rates, combined with a low event rate and improved procedural characteristics, support further use of the hybrid algorithm for a broad community of appropriately trained CTO operators.
Notes: [Maeremans, Joren; Dens, Joseph] Univ Hasselt, Fac Med & Life Sci, Hasselt, Belgium. [Maeremans, Joren; Dens, Joseph] Ziekenhuis Oost Limburg, Dept Cardiol, Schiepse Bos 6, B-3600 Genk, Belgium. [Walsh, Simon; Hanratty, Colm G.] Belfast City Hosp, Dept Cardiol, Belfast, Antrim, North Ireland. [Knaapen, Paul] Vrije Univ Amsterdam, Med Ctr, Dept Cardiol, Amsterdam, Netherlands. [Spratt, James C.] Forth Valley Royal Hosp, Dept Cardiol, Edinburgh, Midlothian, Scotland. [Avran, Alexandre] Clin Marignane, Dept Cardiol, Marignane, France. [Faurie, Benjamin] Grp Hosp Mutualiste, Dept Cardiol, Grenoble, France. [Agostoni, Pierfrancesco] Univ Med Ctr Utrecht, Dept Cardiol, Utrecht, Netherlands. [Agostoni, Pierfrancesco] St Antonius Hosp, Dept Cardiol, Nieuwegein, Netherlands. [Bressollette, Erwan] Nouvelles Clin Nantaises, Dept Cardiol, Nantes, France. [Kayaert, Peter] Univ Ziekenhuis Brussel, Dept Cardiol, Brussels, Belgium. [Bagnall, Alan J.; Egred, Mohaned] Freeman Rd Hosp, Dept Cardiol, Newcastle Upon Tyne, Tyne & Wear, England. [Bagnall, Alan J.; Egred, Mohaned] Newcastle Univ, Inst Cellular Med, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England. [Smith, Dave; Chase, Alexander] Morriston Hosp, Dept Cardiol, Swansea, W Glam, Wales. [McEntegart, Margaret B.] Golden Jubilee Natl Hosp, Dept Cardiol, Glasgow, Lanark, Scotland. [Smith, William H. T.; Harcombe, Alun] Univ Nottingham Hosp, Dept Cardiol, Nottingham, England. [Kelly, Paul] Basildon Hosp, Essex Cardiothorac Ctr, Dept Cardiol, Basildon, Essex, England. [Irving, John] Ninewells Hosp, Dept Cardiol, Dundee, Scotland. [Smith, Elliot J.] Barts Hlth NHS Trust, Barts Heart Ctr, Dept Cardiol, London, England. [Strange, Julian W.] Bristol Heart Inst, Dept Cardiol, Bristol, Avon, England.
URI: http://hdl.handle.net/1942/22820
DOI: 10.1016/j.jacc.2016.08.034
ISI #: 000386828100005
ISSN: 0735-1097
Category: A1
Type: Journal Contribution
Validation: ecoom, 2017
Appears in Collections: Research publications

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