{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T05:15:49Z","timestamp":1775106949870,"version":"3.50.1"},"reference-count":12,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T00:00:00Z","timestamp":1770508800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T00:00:00Z","timestamp":1770508800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>HydroDynamic Recanalization (HDR) is a novel technique for crossing coronary chronic total occlusions (CTOs) that involves intraplaque contrast injection followed by polymer\u2010jacketed guidewire advancement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The aim of this study is to compare the technical and procedural outcomes, and safety of CTO PCIs performed with HDR versus (vs.) without HDR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed the baseline clinical and angiographic characteristics and outcomes of HDR\u2010treated patients in the multicenter PROGRESS\u2010CTO registry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 1807 CTO percutaneous coronary interventions (PCIs) (1797 patients) performed in 2025, HDR was utilized in 90 (5%) cases. HDR patients had similar baseline clinical characteristics with non\u2010HDR patients, although a history of prior PCI was more common among HDR patients (75.3% vs. 60.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006). HDR\u2010treated patients were less likely to have interventional collaterals (38.2% vs. 55.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) but more likely to have in\u2010stent restenosis (35.6% vs. 14.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). HDR cases had higher prevalence of blunt\/no stump (62.2% vs. 50.1%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.025), smaller lesion diameter (2.88\u2009\u00b1\u20090.67 vs. 3.03\u2009\u00b1\u20090.55,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011), and less frequently side branch at the proximal cap (43.7% vs. 64.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). They had higher J\u2010CTO (2.63\u2009\u00b1\u20091.10 vs. 2.29\u2009\u00b1\u20091.14,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006), PROGRESS\u2010CTO (1.33\u2009\u00b1\u20091.02 vs. 1.13\u2009\u00b1\u20090.93,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048) and PROGRESS\u2010CTO MACE (3.06\u2009\u00b1\u20091.55 vs. 2.65\u2009\u00b1\u20091.67,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014) scores. Antegrade wiring was both the first and the most successful crossing strategy in both groups. HDR cases had significantly longer procedural (131 [107, 174] vs. 109 [74, 151] min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), fluoroscopy (48 [34, 70] vs. 39 [25, 61]) min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), and crossing (39 [22, 86] vs. 25 [11, 56] min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) time compared with non\u2010HDR cases. Technical success was lower in HDR patients (80.0% vs. 88.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.024), while MACE (1.1% vs. 2.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.7) was not different between the two groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HDR was performed in 5% of CTO PCIs in 2025, in more complex lesions and was associated with lower technical success but similar MACE compared with patients who underwent CTO PCI without HDR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70502","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T07:24:18Z","timestamp":1770621858000},"page":"1450-1455","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["HydroDynamic Recanalization for Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From the PROGRESS\u2010CTO Registry"],"prefix":"10.1002","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9067-4692","authenticated-orcid":false,"given":"Eleni","family":"Kladou","sequence":"first","affiliation":[{"name":"Minneapolis Heart Institute and Minneapolis Heart Institute Foundation Abbott Northwestern Hospital Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6623-1715","authenticated-orcid":false,"given":"Dimitrios","family":"Strepkos","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute and Minneapolis Heart Institute Foundation Abbott Northwestern Hospital Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9549-0748","authenticated-orcid":false,"given":"Michaella","family":"Alexandrou","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute and Minneapolis Heart Institute Foundation Abbott Northwestern Hospital Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0918-6759","authenticated-orcid":false,"given":"Pedro E. P.","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute and Minneapolis Heart Institute Foundation Abbott Northwestern Hospital Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaskanwal Deep Singh","family":"Sara","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute and Minneapolis Heart Institute Foundation Abbott Northwestern Hospital Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khaldoon","family":"Alaswad","sequence":"additional","affiliation":[{"name":"Henry Ford Cardiovascular Division Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mir B.","family":"Basir","sequence":"additional","affiliation":[{"name":"Henry Ford Cardiovascular Division Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5419-913X","authenticated-orcid":false,"given":"Dmitrii","family":"Khelimskii","sequence":"additional","affiliation":[{"name":"Meshalkin Novosibirsk Research Institute Novosibirsk Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farouc A.","family":"Jaffer","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nidal Abi","family":"Rafeh","sequence":"additional","affiliation":[{"name":"North Oaks Healthcare System Hammond Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raj","family":"Chandwaney","sequence":"additional","affiliation":[{"name":"Oklahoma Heart Institute Tulsa Oklahoma USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cihan","family":"Cevik","sequence":"additional","affiliation":[{"name":"UC Health Memorial Hospital Colorado Springs Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yousif","family":"Ahmad","sequence":"additional","affiliation":[{"name":"University of California San Francisco San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5810-4991","authenticated-orcid":false,"given":"Salman A.","family":"Arain","sequence":"additional","affiliation":[{"name":"Department of Cardiology McGovern School of Medicine University of Texas Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2326-4749","authenticated-orcid":false,"given":"Mauro","family":"Carlino","sequence":"additional","affiliation":[{"name":"IRCCS San Raffaele Scientific Institute Milan 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USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Voudris","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute and Minneapolis Heart Institute Foundation Abbott Northwestern Hospital Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yader","family":"Sandoval","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute and Minneapolis Heart Institute Foundation Abbott Northwestern Hospital Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Nicholas Burke","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute and Minneapolis Heart Institute Foundation Abbott Northwestern Hospital Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9416-9701","authenticated-orcid":false,"given":"Emmanouil 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