Balloon-assisted subintimal entry (BASE) in chronic total occlusion percutaneous coronary interventions
Michaella Alexandrou MD
Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
Search for more papers by this authorAthanasios Rempakos MD
Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
Search for more papers by this authorAhmed Al Ogaili MD
Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
Search for more papers by this authorJames W. Choi MD
Texas Health Presbyterian Hospital, Dallas, Texas, USA
Search for more papers by this authorPaul Poommipanit MD
University Hospitals, Case Western Reserve University, Cleveland, Ohio, USA
Search for more papers by this authorKhaldoon Alaswad MD
Henry Ford Cardiovascular Division, Detroit, Michigan, USA
Search for more papers by this authorMir B. Basir DO
Henry Ford Cardiovascular Division, Detroit, Michigan, USA
Search for more papers by this authorRhian Davies DO, MS
WellSpan York Hospital, York, Pennsylvania, USA
Search for more papers by this authorStewart Benton MD
WellSpan York Hospital, York, Pennsylvania, USA
Search for more papers by this authorFarouc A. Jaffer MD, PhD
Massachusetts General Hospital, Boston, Massachusetts, USA
Search for more papers by this authorRaj H. Chandwaney MD
Oklahoma Heart Institute, Tulsa, Oklahoma, USA
Search for more papers by this authorLorenzo Azzalini MD, PhD, MSc
Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA
Search for more papers by this authorKathleen E. Kearney MD
Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA
Search for more papers by this authorAhmed M. ElGuindy MD
Aswan Heart Center, Magdi Yacoub Foundation, Cairo, Egypt
Search for more papers by this authorNidal Abi Rafeh MD
North Oaks Health System, Hammond, Louisiana, USA
Search for more papers by this authorOmer Goktekin MD
Memorial Bahcelievler Hospital, Istanbul, Turkey
Search for more papers by this authorSevket Gorgulu MD
Biruni University Medical School, Istanbul, Turkey
Search for more papers by this authorMinh N. Vo MD
Royal Columbian Hospital, Vancouver, British Columbia, Canada
Search for more papers by this authorAltug Cincin MD
Marmara University School of Medicine Pendik, Training and Research Hospital, Kaynarca, Turkey
Search for more papers by this authorBavana V. Rangan BDS, MPH
Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
Search for more papers by this authorOlga C. Mastrodemos BA
Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
Search for more papers by this authorSalman S. Allana MD
Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
Search for more papers by this authorYader Sandoval MD
Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
Search for more papers by this authorM. Nicholas Burke MD
Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
Search for more papers by this authorCorresponding Author
Emmanouil S. Brilakis MD, PhD
Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
Correspondence Emmanouil S. Brilakis, MD, PhD, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, 920 E 28th St #300, Minneapolis, MN 55407, USA.
Email: [email protected]
Search for more papers by this authorMichaella Alexandrou MD
Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
Search for more papers by this authorAthanasios Rempakos MD
Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
Search for more papers by this authorAhmed Al Ogaili MD
Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
Search for more papers by this authorJames W. Choi MD
Texas Health Presbyterian Hospital, Dallas, Texas, USA
Search for more papers by this authorPaul Poommipanit MD
University Hospitals, Case Western Reserve University, Cleveland, Ohio, USA
Search for more papers by this authorKhaldoon Alaswad MD
Henry Ford Cardiovascular Division, Detroit, Michigan, USA
Search for more papers by this authorMir B. Basir DO
Henry Ford Cardiovascular Division, Detroit, Michigan, USA
Search for more papers by this authorRhian Davies DO, MS
WellSpan York Hospital, York, Pennsylvania, USA
Search for more papers by this authorStewart Benton MD
WellSpan York Hospital, York, Pennsylvania, USA
Search for more papers by this authorFarouc A. Jaffer MD, PhD
Massachusetts General Hospital, Boston, Massachusetts, USA
Search for more papers by this authorRaj H. Chandwaney MD
Oklahoma Heart Institute, Tulsa, Oklahoma, USA
Search for more papers by this authorLorenzo Azzalini MD, PhD, MSc
Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA
Search for more papers by this authorKathleen E. Kearney MD
Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA
Search for more papers by this authorAhmed M. ElGuindy MD
Aswan Heart Center, Magdi Yacoub Foundation, Cairo, Egypt
Search for more papers by this authorNidal Abi Rafeh MD
North Oaks Health System, Hammond, Louisiana, USA
Search for more papers by this authorOmer Goktekin MD
Memorial Bahcelievler Hospital, Istanbul, Turkey
Search for more papers by this authorSevket Gorgulu MD
Biruni University Medical School, Istanbul, Turkey
Search for more papers by this authorMinh N. Vo MD
Royal Columbian Hospital, Vancouver, British Columbia, Canada
Search for more papers by this authorAltug Cincin MD
Marmara University School of Medicine Pendik, Training and Research Hospital, Kaynarca, Turkey
Search for more papers by this authorBavana V. Rangan BDS, MPH
Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
Search for more papers by this authorOlga C. Mastrodemos BA
Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
Search for more papers by this authorSalman S. Allana MD
Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
Search for more papers by this authorYader Sandoval MD
Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
Search for more papers by this authorM. Nicholas Burke MD
Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
Search for more papers by this authorCorresponding Author
Emmanouil S. Brilakis MD, PhD
Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
Correspondence Emmanouil S. Brilakis, MD, PhD, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, 920 E 28th St #300, Minneapolis, MN 55407, USA.
Email: [email protected]
Search for more papers by this authorAbstract
Background
There is limited data on the use of the balloon-assisted subintimal entry (BASE) technique in chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Methods
We analyzed the baseline clinical and angiographic characteristics and outcomes of 155 CTO PCIs that utilized the BASE technique at 31 US and non-US centers between 2016 and 2023.
Results
The BASE technique was used in 155 (7.9%) of 1968 antegrade dissection and re-entry (ADR) cases performed during the study period. The mean age was 66 ± 10 years, 88.9% of the patients were men, and the prevalence of diabetes (44.6%), hypertension (90.5%), and dyslipidemia (88.7%) was high. Compared with 1813 ADR cases that did not use BASE, the target vessel of the BASE cases was more commonly the RCA and less commonly the LAD. Lesions requiring BASE had longer occlusion length (42 ± 23 vs. 37 ± 23 mm, p = 0.011), higher Japanese CTO (J-CTO) (3.4 ± 1.0 vs. 3.0 ± 1.1, p < 0.001) and PROGRESS-CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention chronic total occlusion) (1.8 ± 1.0 vs. 1.5 ± 1.0, p = 0.008) scores, and were more likely to have proximal cap ambiguity, side branch at the proximal cap, blunt/no stump, moderate to severe calcification, and proximal tortuosity. Technical (71.6% vs. 75.5%, p = 0.334) and procedural success (71.6% vs. 72.8%, p = 0.821), as well as major adverse cardiac events (MACE) (1.3% vs. 4.1%, p = 0.124), were similar in ADR cases that used BASE and those that did not.
Conclusions
The BASE technique is used in CTOs with longer occlusion length, higher J-CTO score, and more complex angiographic characteristics, and is associated with moderate success but also low MACE.
CONFLICT OF INTEREST STATEMENT
The authors declare no conflict of interest.
Open Research
DATA AVAILABILITY STATEMENT
Research data are not shared.
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