International percutaneous coronary intervention complication survey

Abstract

Objectives: To investigate the perceptions of interventional cardiologists (IC) regarding the frequency, impact, and management strategies of percutaneous coronary intervention (PCI) complications.Background: The perceptions and management strategies of ICs of PCI complications have received limited study.Methods: Online survey on PCI complications: 46 questions were distributed via email lists and Twitter to ICs.Results: Of 11,663 contacts, 821 responded (7% response rate): 60% were from the United States and the median age was 46-50 years. Annual PCI case numbers were <100 (26%), 100-199 (37%), 200-299 (21%), and ≥300 (16%); 42% do not perform structural interventions, others reported performing <40 (30%), or >100 (11%) structural cases annually. On a scale of 0-10, participating ICs were highly concerned about potential complications with a median score of 7.2 (interquartile range: 5.0-8.7). The most feared complication was death (39%), followed by coronary perforation (26%) and stroke (9%). Covered stents were never deployed by

Educational Experience of Interventional Cardiology Fellows in the United States and Canada

“…Similarly, a recent survey of interventional cardiologists reported presentations at meetings (66%) and webinars (48%) as the most useful learning sources. 38 This highlights that fellows prefer more “digestible” material and demonstrates opportunities to expand video- and web-based training material, but without compromising accuracy and quality.…”

Impact of proximal cap ambiguity on the procedural techniques and outcomes of chronic total occlusion percutaneous coronary intervention: Insights from the PROGRESS‐CTO Registry

“…The perforation rate was also higher in ambiguous proximal cap CTOs (6.7% vs. 3.6%; p < 0.001), but the incidence of tamponade requiring pericardiocentesis was similar in both groups (1.1% vs. 0.8%; p = 0.177). This may be related to higher utilization of the retrograde approach among cases with an ambiguous proximal cap and worse baseline clinical characteristics, such as low ejection fraction 22 and should be taken into account when deciding to recanalize such CTOs 23 . The overall procedural efficiency was also lower among cases with an ambiguous cap (longer procedure and fluoroscopy time, higher utilization of contrast and radiation) (Figure 2).…”

Intravascular lithotripsy in chronic total occlusion percutaneous coronary intervention: Insights from the PROGRESS‐CTO registry

“…1,3 The presence of calcium has been associated with lower technical success and higher risk of complications 2,15,16 highlighting the importance of preparation to prevent periprocedural adverse events. 17 As a device that delivers localized pulsatile sonic pressure waves to circumferentially modify vascular calcium, IVL can be used to disrupt and induce circumferential fracture in calcific plaques, altering vessel compliance, and facilitating optimal stent expansion. 18 In our study, IVL was used in 57 cases with severe calcification, and technical success was achieved in 94.7% of these cases.…”

“…Coronary calcification can hinder CTO PCI by impairing wire advancement and penetration, affecting equipment delivery, and preventing stent expansion 1,3 . The presence of calcium has been associated with lower technical success and higher risk of complications 2,15,16 highlighting the importance of preparation to prevent periprocedural adverse events 17 . As a device that delivers localized pulsatile sonic pressure waves to circumferentially modify vascular calcium, IVL can be used to disrupt and induce circumferential fracture in calcific plaques, altering vessel compliance, and facilitating optimal stent expansion 18 .…”