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Sharma V, Jadhav ST, Harcombe AA, Kelly PA, Mozid A, Bagnall A, Richardson J, Egred M, McEntegart M, Shaukat A, Oldroyd K, Vishwanathan G, Rana O, Talwar S, McPherson M, Strange JW, Hanratty CG, Walsh SJ, Spratt JC, Smith WHT. Impact of proctoring on success rates for percutaneous revascularisation of coronary chronic total occlusions. Open Heart 2015; 2:e000228. [PMID: 25852949 PMCID: PMC4379886 DOI: 10.1136/openhrt-2014-000228] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 01/30/2015] [Accepted: 03/04/2015] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To assess the impact of proctoring for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in six UK centres. METHODS We retrospectively analysed 587 CTO procedures from six UK centres and compared success rates of operators who had received proctorship with success rates of the same operators before proctorship (pre-proctored) and operators in the same institutions who had not been proctored (non-proctored). There were 232 patients in the pre-proctored/non-proctored group and 355 patients in the post-proctored group. Complexity was assessed by calculating the Japanese CTO (JCTO) score for each case. RESULTS CTO PCI success was greater in the post-proctored compared with the pre-proctored/non-proctored group (77.5% vs 62.1%, p<0.0001). In more complex cases where JCTO≥2, the difference in success was greater (70.7% vs 49.5%, p=0.0003). After proctoring, there was an increase in CTO PCI activity in centres from 2.5% to 3.5%, p<0.0001 (as a proportion of total PCI), and the proportion of very difficult cases with JCTO score ≥3 increased from 15.3% (35/229) to 29.7% (105/354), p<0.0001. CONCLUSIONS Proctoring resulted in an increase in procedural success for CTO PCI, an increase in complex CTO PCI and an increase in total CTO PCI activity. Proctoring may be a valuable way to improve access to CTO PCI and the likelihood of procedural success.
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Affiliation(s)
- Vinoda Sharma
- Trent Cardiac Centre, Nottingham City Hospital , Nottingham , UK
| | - S T Jadhav
- Trent Cardiac Centre, Nottingham City Hospital , Nottingham , UK
| | - A A Harcombe
- Trent Cardiac Centre, Nottingham City Hospital , Nottingham , UK
| | - P A Kelly
- The Essex Cardiothoracic Centre , Essex , UK
| | - A Mozid
- The Essex Cardiothoracic Centre , Essex , UK
| | - A Bagnall
- Freeman Hospital , Newcastle upon Tyne , UK
| | | | - M Egred
- Freeman Hospital , Newcastle upon Tyne , UK
| | - M McEntegart
- Golden Jubilee National Hospital , Clydebank , UK
| | - A Shaukat
- Golden Jubilee National Hospital , Clydebank , UK
| | - K Oldroyd
- Golden Jubilee National Hospital , Clydebank , UK
| | | | - O Rana
- Royal Bournemouth Hospital , Bournemouth , UK
| | - S Talwar
- Royal Bournemouth Hospital , Bournemouth , UK
| | | | | | | | - S J Walsh
- Belfast City Hospital , Belfast , UK
| | - J C Spratt
- Forth Valley Royal Hospital , Larbert , UK
| | - W H T Smith
- Trent Cardiac Centre, Nottingham City Hospital , Nottingham , UK
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Brady PA, Erne P, Val-Mejias J, Schwab J, Schimpf R, Orlov M, Mattioni T, Amlie J, Itou H, Igarashi M, Iga A, Tubota T, Yamazaki J, Yoshihara K, Santos De Sousa CI, Carpinteiro L, Marques P, Almeida MR, Miltemberger G, Correia MJ, Sousa J, Lopes M, Teixeira R, Ferreira MJ, Donato P, Ventura M, Cristovao J, Elvas L, Providencia LA, Chang D, Zhang S, Gao L, Yang D, Lin Y, Chu Z, Yang Y, Pecini R, Pehrson S, Chen X, Thoegersen AM, Kjaer A, Hastrup-Svendsen J, Sanchez-Munoz JJ, Garcia-Alberola A, Martinez-Sanchez J, Penafiel-Verdu P, Giner-Caro JA, Pastor-Perez FJ, Valdes-Chavarri M, Sorrentino S, Forleo C, Iacoviello M, Guida P, D'andria V, Favale S, Pasceri E, Curcio A, Achille F, De Serio D, Zinzi S, Torella D, Mastroroberto P, Indolfi C, Ozcan Celebi O, Canbay A, Aydogdu S, Diker E, De Sisti A, Tonet J, Benkaci A, Frank R, Sanchez-Munoz JJ, Garcia-Alberola A, Martinez-Sanchez J, Penafiel Verdu P, Giner Caro JA, Pastor-Perez FJ, Valdes-Chavarri M, Maroz-Vadalazhskaya N, Denissevich T, Ostrovskiy I, Sharashidze N, Pagava Z, Saatashvili G, Agladze R, Noda M, Yoshikawa S, Fujinami T, Yamamoto Y, Tashiro H, Usui M, Ichikawa K, Isobe M, Meyer C, Saygili E, Rana O, Floege J, Hennersdorf M, Rassaf T, Kelm M, Schauerte P, Sredniawa B, Cebula S, Kowalczyk J, Musialik-Lydka A, Wozniak A, Zakliczynski M, Zembala M, Kalarus Z, Gumenyuk OI, Chernenkov YV, Kosenkova IV, Bolotova NV, Averyanov AP. Poster Session 4: Miscellaneous. Europace 2009. [DOI: 10.1093/europace/euq239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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