1. European Registry Update
Georgios Sianos, MD, PhD, FESC
Aristotle University, AHEPA University Hospital
Thessaloniki, Greece

2. Disclosure Statement of Financial Interest
I, Georgios Sianos, DO NOT have a financial interest/arrangement or affiliation with one or more organizations that could be perceived as a real or apparent conflict of interest in the context of the subject of this presentation.
All CTO 2015 faculty disclosures are listed on the CRF Events App.

3. Euro CTO Club Membership

4. Web based ERCTO Registry

5. Online Registry

6. Antegrade /Retrograde
Operators
N=24
N=29
N=35
N=44
N=48
N=48
N=42

7. Antegrade /Retrograde
Procedures

8. Angiographic Success %

9. Angiographic Success %

10. Procedural Success by JCTO Score according to Experience in Retrograde%
Low = <50 procedure retrograde
Moderate = retrograde
Good = >100 retrograde

11. Multivariate logistic regression analysis associated with technical failure in retrograde approach
Variable OR
95% CI
p-value
Age, per 10-yr increase
1.19
0.01
Men
0.70
0.08
Diabetes
1.16
0.33
Ejection fraction <35%
0.89
0.68
History of MI, %
0.91
0.50
History of CABG, %
1.22
0.26
Prior PCI, %
0.98
0.87
Occlusion duration <12 months
0.95
0.55
Occlusion length < 20 mm
1.00
0.99
Operator Experience
<50 versus >100
versus >100
3.07
2.17
<0.0001
J-CTO Score
Intermediate versus very difficult
Medium difficult versus very difficult
Quite difficult versus very difficult
0.44
0.42
0.61

12. Wires to start %

13. Wires to start (Fielder XT Family)%

14. Final wires %

15. Guiding Catheter Selection in the ERCTO%
53,8
49,8
49,8
48,5
48,3
45,8
43,5
40,9
37,8
35,4
15,6
10,9
8,7
7,4
7,9
2010
2011
2012
2013
2014
6 French
7 French
8 French
No trend differences were observed between antegrade and retrograde approach during years

16. Procedural Details % Controlateral injection Radial approach 2010 2011
61,6
54,4
53,7
49,4
47,2
17,5
15,7 15
12,2
8,6
2010
2011
2012
2013
2014
Controlateral injection
Radial approach

17. Use of Dedicated Devices%

18. IVUS %

19. Procedural Complications
Death
Cardiac tamponade
Myocardial infarction
Vascular complication
Coronary perforation
Donor vessel dissection

20. 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
Courtesy C Reifart

21. 2015 and on
10 % reabstraction of CTO records (n = 250/ year), masked and reviewed by a second abstractor

22. At random : „ your patient was selected for monitoring“
Automatic export of registry parameters 9
parameters to be checked by reviewer

23. CD will automatically be uploaded (Videoloader)
It automatically stores all files to prepare
Operator

24. At least 4 cineruns to be uploaded
CTO vessel with retrograde/antegrade distal filling;
Wire passage
If applicable also for retrograde access
Final result showing residual lesion and runoff.

25. Add requested runs to file

26. Any run can be played at high resolution and be reviewed

27. 1 2 3 4 7
5/ 6

28. 8 9

29. Monitor
The monitor will evaluate the case in a structured way that finally  results in an
agreement
agreement with slight differences or
relevant disagreement (i.e. no CTO or no TIMI 3 flow)

30. Test: Operator NR Monitor GW

31. Calculated accordance 84 %

32. 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