Adham Ramadan

Among the criticisms of #CTO #PCI is the higher risk compared to regular PCI procedures. This perception stems from the procedure's higher complexity. The unmeasured factor is that CTO PCI is usually performed by operators who can identify and treat possible complications faster and have the awareness to prevent problems or manage them. Our study from the National Trinetix database @MyJSCAI, led by @AdhamGR97 and @MohamedDomaa, compared 30-day outcomes between CTO PCI and ELECTIVE (non-MI) non-CTO PCI, and also trended outcomes over three recent periods (2014-2017, 2018-2021, 2022-2025). Our major findings are as follows 1-CTO PCI risk of pericardiocentesis was higher than non-CTO PCI (0.2% vs 0.09%) but remains very small at 0.2% 2-CABG after CTO PCI was higher than non-CTO PCI; we could not determine the cause, but it was mostly related to failure and the need for revascularization rather than complications. Also, the trend of CABG after CTO PCI has been decreasing. 3-Finally, none of this led to adverse outcomes, as there was absolutely no difference in mortality between the two groups. In the hands of experienced operators, CTO PCI can be safe and effective. sciencedirect.com/science/ar… #CardioX #ACCFIT

#CTO #PCI in cardiogenic shock, shall we even do it? Our study led by @MohamedDomaa and @AdhamGR97 in the @CJCJournals investigated the long-term outcomes of patients who already had a diagnosis of cardiogenic shock and underwent CTO PCI in the same hospitalization. While the in-hospital mortality is around 27% (which is way lower than the 40-50% cited mortality of cardiogenic shock), the long-term survival was even more impressive, with a 5-year survival of 60%. We stipulate that the reason CTO PCI was performed was either that further revascularization was needed (e.g., inability to wean from mechanical circulatory support) or that the culprit of shock was NSTEMI with multiple CTOs (18% of our cohort) Any other reason you would do CTO PCI in shock? onlinecjc.ca/article/S0828-2…

Please check out our most recent @pace_journal publication on the risk of recurrent GI bleeding in AF patients undergoing LAAO.🫀🩸 @DrDeese99 @MohamedDomaa #AtrialFibrillation #LAAO #EPeeps #CardioTwitter