{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T11:11:00Z","timestamp":1780312260693,"version":"3.54.0"},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"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":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic thromboembolic pulmonary disease (CTEPD) leads to chronic total occlusions (CTOs) of the pulmonary arteries in a minority of patients. Treatment of CTOs with balloon pulmonary angioplasty (BPA) may substantially improve patient hemodynamics but presents unique technical challenges and has previously been associated with a low success rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective registry of CTEPD patients who underwent CTO BPA at the University of Washington from August 2019 to July 2024 was included. Rates of technical success, methods of successful revascularization, and hemodynamic outcomes are reported. Outcomes were compared to a cohort of non\u2010CTO BPA interventions, evaluating differences in hemodynamic outcomes and overall complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eighty\u2010four CTO lesions were intervened upon in 37 patients. On a per\u2010lesion basis, 94% of CTOs were revascularized, with an 80% success rate on the first attempt. Most cases of subintimal and\/or extravascular entry were treated with the novel Microcatheter Injection, Retraction, and Reentry (MIRaR) technique. Follow\u2010up patency rate was 96%, and the total per\u2010procedure complication rate was 10%, the majority of which were clinically insignificant. Although mean pulmonary artery pressure, cardiac index, pulmonary vascular resistance, and pulmonary vascular compliance were significantly worse in the CTO group at baseline, no significant differences persisted after intervention. Both total and clinically meaningful complication rates were similar between cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We report the highest rate of successful CTO revascularization to date with a low overall intra\u2010procedural complication rate. Novel technical approaches to managing subintimal wire entry may be responsible for our observed success.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70611","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T10:29:47Z","timestamp":1775471387000},"page":"2323-2334","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Successful Revascularization of Chronic Total Occlusions in Patients With Chronic Thromboembolic Pulmonary Disease"],"prefix":"10.1002","volume":"107","author":[{"given":"Elliot J.","family":"Stein","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Cardiology University of Washington Medical Center Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5716-248X","authenticated-orcid":false,"given":"Peter 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