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A CHIP fellow's transition into practice: Building a complex coronary therapeutics program.

Robert F Riley1, Timothy D Henry1, James A Kong1

  • 1Lindner Center for Research and Education, The Christ Hospital Network, Cincinnati, Ohio.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|November 26, 2019
PubMed
Summary
This summary is machine-generated.

Complex high-risk indicated PCI (CHIP) fellowship training improved chronic total occlusion (CTO) procedure success rates. This study demonstrates the value of specialized CHIP programs in managing complex coronary artery disease.

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Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology

Background:

  • Coronary artery disease (CAD) prevalence and complexity are increasing.
  • A gap exists in complex CAD treatment due to declining percutaneous coronary intervention (PCI) volumes and limited formal education.
  • Complex, High-risk, and Indicated PCI (CHIP) fellowships aim to address this educational gap.

Purpose of the Study:

  • To evaluate the impact of a formal CHIP program and fellowship training on the management of complex coronary interventions.
  • To present practice data from the initial year of a newly established CHIP program.

Main Methods:

  • Prospective data collection for PCIs performed during the first 12 months of practice by a CHIP fellow.
  • Comparison of PCI data with the 12 months preceding the study period.
  • Analysis of procedural characteristics and outcomes for complex PCI, including chronic total occlusions (CTOs).

Main Results:

  • During the study period, 53.4% of 371 PCIs were complex, with 126 CTO procedures.
  • A significant increase in the number and complexity (median J-CTO score 2.1 vs. 1.3, p=0.04) of CTOs was observed compared to the prior year.
  • CTO PCI achieved high technical (93.4%) and procedural (85.7%) success rates, with complication rates comparable to national registries.

Conclusions:

  • Establishment of a formal CHIP program following fellowship training led to procedural success and complication rates similar to high-volume centers.
  • Specialized training and dedicated programs enhance the delivery of complex coronary interventions.