{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T20:59:05Z","timestamp":1758056345266,"version":"3.44.0"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,3,3]],"date-time":"2024-03-03T00:00:00Z","timestamp":1709424000000},"content-version":"vor","delay-in-days":2,"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>Guide catheter extensions (GCEs) increase support and facilitate equipment delivery, but aggressive instrumentation may be associated with a higher risk of complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>Our aim was to assess the impact of GCEs on procedural success and complications in patients submitted to chronic total occlusion (CTO) percutaneous coronary intervention (PCI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed data from the multicenter LATAM CTO Registry. Procedural success was defined as &lt;30% residual stenosis and TIMI 3 distal flow. Major adverse cardiac and cerebrovascular events (MACCE) was defined as the composite of all\u2010cause death, myocardial infarction, target vessel revascularization, and stroke. Propensity score matching (PSM) was used to compare outcomes with and without GCE use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From August 2010 to August 2021, 3049 patients were included. GCEs were used in 438 patients (14.5%). In unadjusted analysis, patients in the\u00a0GCE group were older and had more comorbidities. The median\u00a0J\u2010CTO score and its components were higher in the GCE group. After PSM, procedural success was higher with GCE use (87.7% vs. 80.5%, <jats:italic>p<\/jats:italic>\u2009=\u20090.007). The incidence of coronary perforation (odds ratio [OR]: 1.46, 95% confidence interval [CI]: 0.78\u20132.71, <jats:italic>p<\/jats:italic>\u2009=\u20090.230), bleeding (OR: 1.99, 95% CI: 0.41\u20132.41, <jats:italic>p<\/jats:italic>\u2009=\u20090.986), in\u2010hospital death (OR: 1.39, 95% CI: 0.54\u20133.62, <jats:italic>p<\/jats:italic>\u2009=\u20090.495) and MACCE (OR: 1.07, 95% CI: 0.52\u20132.19, <jats:italic>p<\/jats:italic>\u2009=\u20090.850) were similar in both groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In a contemporary, multicenter cohort of patients undergoing CTO PCI, GCEs were used in older patients, with more comorbidities and complex anatomy. After PSM, GCE use was associated with higher procedural success, and similar incidence of adverse outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30987","type":"journal-article","created":{"date-parts":[[2024,3,3]],"date-time":"2024-03-03T09:59:20Z","timestamp":1709459960000},"page":"539-547","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Guide catheter extension use are associated with higher procedural success in chronic total occlusion percutaneous coronary interventions"],"prefix":"10.1002","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9926-5081","authenticated-orcid":false,"given":"Evandro M.","family":"Filho","sequence":"first","affiliation":[{"name":"Santa Casa de Miseric\u00f3rdia de Macei\u00f3 Macei\u00f3 Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1989-1670","authenticated-orcid":false,"given":"Gustavo N.","family":"Araujo","sequence":"additional","affiliation":[{"name":"Imperial Hospital de Caridade Florian\u00f3polis Brazil"},{"name":"Instituto de Cardiologia de Santa Catarina S\u00e3o Jos\u00e9 Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5514-2562","authenticated-orcid":false,"given":"Guilherme P.","family":"Machado","sequence":"additional","affiliation":[{"name":"Hospital de Cl\u00ednicas de Porto Alegre Porto Alegre Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucio","family":"Padilla","sequence":"additional","affiliation":[{"name":"Instituto Cardiovascular de Buenos Aires Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo\u00e3o E. T.","family":"de Paula","sequence":"additional","affiliation":[{"name":"Instituto Cardiovascular de Linhares UNICOR Linhares Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio C.","family":"Botelho","sequence":"additional","affiliation":[{"name":"Hospital S\u00e3o Jos\u00e9 do Ava\u00ed Itaperuna Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1734-6924","authenticated-orcid":false,"given":"Carlos M.","family":"Campos","sequence":"additional","affiliation":[{"name":"Heart Institute (InCor) University of S\u00e3o Paulo Medical School S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franklin L. 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