{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T20:54:34Z","timestamp":1758056074012,"version":"3.44.0"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,2,8]],"date-time":"2024-02-08T00:00:00Z","timestamp":1707350400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The \u201cMinimalistic Hybrid Approach\u201d (MHA) has been proposed to reduce the invasiveness of chronic total occlusion (CTO) percutaneous coronary intervention (PCI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This study aims to assess whether MHA may also reduce the utilization of PCI resources (devices, radiations, and contrast) by comparing it with other conventional algorithms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We aimed to assess the impact of MHA on device, radiation, and contrast usage during CTO\u2010PCI analyzing data from the Belgian Working Group on CTO (BWG\u2010CTO) registry. Patients were divided, depending on the algorithm used, into two groups: Conventional versus Minimalistic. Primary objectives were procedure performance measures such as device usage (microcatheters and guidewires), radiological parameters, and contrast use. At 1\u2010year follow\u2010up, patients were evaluated for target vessel failure (TVF), defined as a composite of cardiac death, new myocardial infarction, and target vessel revascularization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, we analyzed 821 CTO\u2010PCIs (Conventional <jats:italic>n<\/jats:italic>\u2009=\u2009650, Minimalistic <jats:italic>n<\/jats:italic>\u2009=\u2009171). The Minimalistic group demonstrated higher complexity of CTO lesions. After adjusting for propensity score, the Minimalistic group had a significantly lower number of microcatheters used (1.49\u2009\u00b1\u20090.85 vs. 1.24\u2009\u00b1\u20090.64, <jats:italic>p<\/jats:italic>\u2009=\u20090.026), while the number of guidewires was comparable (4.80\u2009\u00b1\u20093.29 vs. 4.35\u2009\u00b1\u20092.94, <jats:italic>p<\/jats:italic>\u2009=\u20090.30). Both groups had similar rates of success and procedural complications, as well as comparable procedural and fluoroscopic times and contrast volume used. At the 1\u2010year follow\u2010up, both groups showed comparable rates of TVF (hazard ratio: 0.57; 95% confidence interval: 0.24\u20131.34, <jats:italic>p<\/jats:italic>\u2009=\u20090.195).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The MHA may slightly reduce the number of dedicated devices used during CTO\u2010PCI, without adversely affecting the procedural success or long\u2010term outcome.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30963","type":"journal-article","created":{"date-parts":[[2024,2,8]],"date-time":"2024-02-08T07:44:05Z","timestamp":1707378245000},"page":"548-559","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Performance of the minimalistic hybrid approach algorithm versus other conventional algorithms in the percutaneous treatment of chronic total occlusions"],"prefix":"10.1002","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3605-505X","authenticated-orcid":false,"given":"Enrico","family":"Poletti","sequence":"first","affiliation":[{"name":"HartCentrum Ziekenhuis Netwerk Antwerpen (ZNA) Middelheim Antwerp Belgium"},{"name":"Department of Clinical and Interventional Cardiology IRCCS Policlinico San Donato San Donato Milanese Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9825-6589","authenticated-orcid":false,"given":"Carlo","family":"Zivelonghi","sequence":"additional","affiliation":[{"name":"HartCentrum Ziekenhuis Netwerk Antwerpen (ZNA) Middelheim Antwerp Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Dens","sequence":"additional","affiliation":[{"name":"Department of Cardiology Ziekenhuis Oost\u2010Limburg Genk Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8301-4517","authenticated-orcid":false,"given":"Johan","family":"Bennett","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine UZ Leuven Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1583-5882","authenticated-orcid":false,"given":"Claudiu","family":"Ungureanu","sequence":"additional","affiliation":[{"name":"Department of Cardiology H\u00f4pital de Jolimont La Louvi\u00e8re Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Coussement","sequence":"additional","affiliation":[{"name":"Department of Cardiology AZ Sint\u2010Jan Brugge Brugge Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daan","family":"Cottens","sequence":"additional","affiliation":[{"name":"Department of Cardiology Ziekenhuis Oost\u2010Limburg Genk 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