{"id":"https://openalex.org/W7204452084","doi":"https://doi.org/10.1097/mca.0000000000001672","title":"Radiation burden in chronic total occlusion percutaneous coronary intervention is driven more by lesion complexity and planned strategy than by the target vessel","display_name":"Radiation burden in chronic total occlusion percutaneous coronary intervention is driven more by lesion complexity and planned strategy than by the target vessel","publication_year":2026,"publication_date":"2026-08-27","ids":{"openalex":"https://openalex.org/W7204452084","doi":"https://doi.org/10.1097/mca.0000000000001672","pmid":"https://pubmed.ncbi.nlm.nih.gov/42657582"},"language":"en","primary_location":{"id":"doi:10.1097/mca.0000000000001672","doi":"https://doi.org/10.1097/mca.0000000000001672","is_oa":false,"landing_page_url":"https://doi.org/10.1097/mca.0000000000001672","pdf_url":null,"source":{"id":"https://openalex.org/S31433238","display_name":"Coronary Artery Disease","issn_l":"0954-6928","issn":["0954-6928","1473-5830"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-c","jufo-1","ki-jl-1","medline","norway-1","poland-40","russia-white-list-2"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Coronary Artery Disease","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5013428517","display_name":"Sefa Sural","orcid":"https://orcid.org/0009-0007-4628-6672","observed_orcids":["https://orcid.org/0009-0007-4628-6672"]},"institutions":[{"id":"https://openalex.org/I12685407","display_name":"Toros University","ror":"https://ror.org/040zce739","country_code":"TR","type":"education","lineage":["https://openalex.org/I12685407"]}],"countries":["TR"],"is_corresponding":false,"raw_author_name":"Sefa Sural","raw_affiliation_strings":["Toros University, Mersin"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Toros University, Mersin","institution_ids":["https://openalex.org/I12685407"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5074960398","display_name":"Semi \u00d6zt\u00fcrk","orcid":"https://orcid.org/0000-0001-5696-6849","observed_orcids":["https://orcid.org/0000-0001-5696-6849"]},"institutions":[{"id":"https://openalex.org/I4210124717","display_name":"Bak\u0131rk\u00f6y Dr.Sadi Konuk E\u011fitim ve Ara\u015ft\u0131rma Hastanesi","ror":"https://ror.org/02smkcg51","country_code":"TR","type":"healthcare","lineage":["https://openalex.org/I4210124717"]}],"countries":["TR"],"is_corresponding":false,"raw_author_name":"Semi Ozturk","raw_affiliation_strings":["Department of Cardiology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Cardiology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul","institution_ids":["https://openalex.org/I4210124717"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5071447477","display_name":"Ahmet Seyfeddin G\u00fcrb\u00fcz","orcid":"https://orcid.org/0000-0002-9225-925X","observed_orcids":["https://orcid.org/0000-0002-9225-925X"]},"institutions":[{"id":"https://openalex.org/I4210107659","display_name":"Necmettin Erbakan University","ror":"https://ror.org/013s3zh21","country_code":"TR","type":"education","lineage":["https://openalex.org/I4210107659"]}],"countries":["TR"],"is_corresponding":false,"raw_author_name":"Ahmet Seyfeddin Gurbuz","raw_affiliation_strings":["Department of Cardiology, Necmettin Erbakan University, Meram Faculty of Medicine, Konya"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Cardiology, Necmettin Erbakan University, Meram Faculty of Medicine, Konya","institution_ids":["https://openalex.org/I4210107659"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5066763910","display_name":"\u015eevket G\u00f6rg\u00fcl\u00fc","orcid":"https://orcid.org/0000-0003-4775-1402","observed_orcids":["https://orcid.org/0000-0003-4775-1402"]},"institutions":[{"id":"https://openalex.org/I4210104933","display_name":"Biruni University","ror":"https://ror.org/01nkhmn89","country_code":"TR","type":"education","lineage":["https://openalex.org/I4210104933"]}],"countries":["TR"],"is_corresponding":false,"raw_author_name":"Sevket Gorgulu","raw_affiliation_strings":["Department of Cardiology, Biruni University, Faculty of Medicine, Istanbul, Turkey"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Cardiology, Biruni University, Faculty of Medicine, Istanbul, Turkey","institution_ids":["https://openalex.org/I4210104933"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":4,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10844","display_name":"Radiation Dose and Imaging","score":0.8823000192642212,"subfield":{"id":"https://openalex.org/subfields/2741","display_name":"Radiology, Nuclear Medicine and Imaging"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10844","display_name":"Radiation Dose and Imaging","score":0.8823000192642212,"subfield":{"id":"https://openalex.org/subfields/2741","display_name":"Radiology, Nuclear Medicine and Imaging"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10193","display_name":"Coronary Interventions and Diagnostics","score":0.11270000040531158,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10372","display_name":"Cardiac Imaging and Diagnostics","score":0.002300000051036477,"subfield":{"id":"https://openalex.org/subfields/2741","display_name":"Radiology, Nuclear Medicine and Imaging"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/chronic-total-occlusion","display_name":"chronic total occlusion","score":0.9629999995231628},{"id":"https://openalex.org/keywords/percutaneous-coronary-intervention","display_name":"percutaneous coronary intervention","score":0.968999981880188},{"id":"https://openalex.org/keywords/radiation-exposure","display_name":"radiation exposure","score":0.9549999833106995},{"id":"https://openalex.org/keywords/fluoroscopy-dose","display_name":"fluoroscopy dose","score":0.6650000214576721},{"id":"https://openalex.org/keywords/right-coronary-artery","display_name":"right coronary artery","score":0.9020000100135803},{"id":"https://openalex.org/keywords/lesion-complexity","display_name":"lesion complexity","score":0.8920000195503235},{"id":"https://openalex.org/keywords/j-cto-score","display_name":"J-CTO score","score":0.9079999923706055},{"id":"https://openalex.org/keywords/air-kerma","display_name":"air kerma","score":0.7730000019073486},{"id":"https://openalex.org/keywords/target-vessel","display_name":"target vessel","score":0.4620000123977661}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9656000137329102},{"id":"https://openalex.org/C45393284","wikidata":"https://www.wikidata.org/wiki/Q191012","display_name":"Conventional PCI","level":3,"score":0.7996000051498413},{"id":"https://openalex.org/C2780400711","wikidata":"https://www.wikidata.org/wiki/Q2008344","display_name":"Percutaneous coronary intervention","level":3,"score":0.789900004863739},{"id":"https://openalex.org/C2776805002","wikidata":"https://www.wikidata.org/wiki/Q614984","display_name":"Fluoroscopy","level":2,"score":0.6266000270843506},{"id":"https://openalex.org/C156957248","wikidata":"https://www.wikidata.org/wiki/Q1862216","display_name":"Odds ratio","level":2,"score":0.5834000110626221},{"id":"https://openalex.org/C2778088351","wikidata":"https://www.wikidata.org/wiki/Q429285","display_name":"Right coronary artery","level":4,"score":0.5758000016212463},{"id":"https://openalex.org/C44249647","wikidata":"https://www.wikidata.org/wiki/Q208498","display_name":"Confidence interval","level":2,"score":0.5648999810218811},{"id":"https://openalex.org/C164705383","wikidata":"https://www.wikidata.org/wiki/Q10379","display_name":"Cardiology","level":1,"score":0.5467000007629395},{"id":"https://openalex.org/C197321550","wikidata":"https://www.wikidata.org/wiki/Q11175","display_name":"Circumflex","level":3,"score":0.5435000061988831},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.4758000075817108},{"id":"https://openalex.org/C2781156865","wikidata":"https://www.wikidata.org/wiki/Q827023","display_name":"Lesion","level":2,"score":0.4081999957561493},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.40139999985694885},{"id":"https://openalex.org/C2781464078","wikidata":"https://www.wikidata.org/wiki/Q7685898","display_name":"Target lesion","level":4,"score":0.3889000117778778},{"id":"https://openalex.org/C2778213512","wikidata":"https://www.wikidata.org/wiki/Q844935","display_name":"Coronary artery disease","level":2,"score":0.3337000012397766},{"id":"https://openalex.org/C79905245","wikidata":"https://www.wikidata.org/wiki/Q175043","display_name":"Dose area product","level":3,"score":0.3246000111103058},{"id":"https://openalex.org/C2777385415","wikidata":"https://www.wikidata.org/wiki/Q1615191","display_name":"Cardiac catheterization","level":2,"score":0.314300000667572},{"id":"https://openalex.org/C2780813298","wikidata":"https://www.wikidata.org/wiki/Q2071287","display_name":"Percutaneous","level":2,"score":0.2969000041484833},{"id":"https://openalex.org/C2776268601","wikidata":"https://www.wikidata.org/wiki/Q968808","display_name":"Occlusion","level":2,"score":0.2922999858856201},{"id":"https://openalex.org/C2776820930","wikidata":"https://www.wikidata.org/wiki/Q9655","display_name":"Artery","level":2,"score":0.2906000018119812},{"id":"https://openalex.org/C3019004856","wikidata":"https://www.wikidata.org/wiki/Q42297149","display_name":"Coronary angiography","level":3,"score":0.28529998660087585},{"id":"https://openalex.org/C2776494729","wikidata":"https://www.wikidata.org/wiki/Q1848900","display_name":"Contraindication","level":3,"score":0.275299996137619},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.26910001039505005},{"id":"https://openalex.org/C2780393670","wikidata":"https://www.wikidata.org/wiki/Q5172192","display_name":"Coronary occlusion","level":3,"score":0.26330000162124634},{"id":"https://openalex.org/C122048520","wikidata":"https://www.wikidata.org/wiki/Q2913954","display_name":"Percentile","level":2,"score":0.2531999945640564}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.1097/mca.0000000000001672","doi":"https://doi.org/10.1097/mca.0000000000001672","is_oa":false,"landing_page_url":"https://doi.org/10.1097/mca.0000000000001672","pdf_url":null,"source":{"id":"https://openalex.org/S31433238","display_name":"Coronary Artery Disease","issn_l":"0954-6928","issn":["0954-6928","1473-5830"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-c","jufo-1","ki-jl-1","medline","norway-1","poland-40","russia-white-list-2"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Coronary Artery Disease","raw_type":"journal-article"},{"id":"pmid:42657582","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42657582","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Coronary artery disease","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[{"score":0.98580002784729,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":10,"referenced_works":["https://openalex.org/W2065661664","https://openalex.org/W2094344671","https://openalex.org/W2182015005","https://openalex.org/W2304260684","https://openalex.org/W2442954115","https://openalex.org/W2784041933","https://openalex.org/W2912382912","https://openalex.org/W2951997824","https://openalex.org/W3088101234","https://openalex.org/W4210312163"],"related_works":["https://openalex.org/W3126944569","https://openalex.org/W4407898204","https://openalex.org/W2904724038","https://openalex.org/W2549483605","https://openalex.org/W2885424435","https://openalex.org/W3203285700","https://openalex.org/W2739867496","https://openalex.org/W4392122187","https://openalex.org/W2765396618","https://openalex.org/W2575417377"],"abstract_inverted_index":{"BACKGROUND:":[0],"Radiation":[1],"exposure":[2,94],"is":[3,23,250],"an":[4],"important":[5],"safety":[6],"issue":[7],"in":[8,44,117,131,215],"chronic":[9],"total":[10],"occlusion":[11],"percutaneous":[12],"coronary":[13,18,80,87],"intervention":[14],"(CTO":[15],"PCI).":[16],"Right":[17],"artery":[19,81,88],"(RCA)":[20],"CTO":[21,57,70,209],"PCI":[22,58,71],"often":[24],"associated":[25,175,220],"with":[26,176,221,230],"a":[27,98],"higher":[28,128,151,212],"radiation":[29,93,178,213,238],"burden,":[30],"but":[31],"it":[32],"remains":[33],"unclear":[34],"whether":[35],"this":[36],"reflects":[37],"the":[38,104,135,163,188,203,211],"target-vessel":[39,231],"location":[40,232],"itself":[41],"or":[42,247],"differences":[43],"lesion":[45,222],"complexity":[46,223],"and":[47,64,127,150,196,224,241],"strategy":[48,141,227],"selection.":[49],"METHODS":[50],"AND":[51],"RESULTS:":[52],"We":[53],"analyzed":[54],"1800":[55],"consecutive":[56],"procedures":[59,119],"performed":[60],"between":[61],"January":[62],"2020":[63],"June":[65],"2025":[66],"at":[67],"three":[68],"participating":[69],"centers":[72],"(RCA":[73],"n":[74,82,89],"=":[75,83,90],"1013;":[76],"left":[77,85],"anterior":[78],"descending":[79],"540;":[84],"circumflex":[86],"247).":[91],"High":[92],"was":[95,115,172,218],"defined":[96],"as":[97],"dose-area":[99],"product":[100],"(DAP)":[101],"greater":[102],"than":[103,229],"90th":[105],"percentile":[106],"among":[107],"available":[108,116],"DAP":[109,114,130,195],"values":[110],"(>35":[111],"400":[112],"cGy\u00b7cm2).":[113],"1321":[118],"(73.4%).":[120],"RCA":[121,216],"cases":[122,217],"had":[123],"longer":[124],"fluoroscopy":[125],"time":[126],"median":[129],"unadjusted":[132],"analyses.":[133],"In":[134,208],"center-adjusted":[136,184],"primary":[137],"model,":[138],"planned":[139],"retrograde/hybrid":[140,226],"(adjusted":[142,154],"odds":[143,155],"ratio:":[144,156],"2.23,":[145],"95%":[146,158],"confidence":[147,159],"interval:":[148,160],"1.42-3.51)":[149],"J-CTO":[152],"score":[153],"1.70,":[157],"1.39-2.09)":[161],"were":[162],"strongest":[164],"predictors":[165],"of":[166],"high":[167],"DAP,":[168],"whereas":[169],"target":[170],"vessel":[171],"not":[173],"independently":[174],"excess":[177],"after":[179],"adjustment.":[180],"A":[181],"Firth":[182],"penalized":[183],"sensitivity":[185],"analysis":[186],"yielded":[187],"same":[189,204],"interpretation.":[190],"Secondary":[191],"analyses":[192],"using":[193],"continuous":[194],"clinically":[197],"relevant":[198],"air":[199],"kerma":[200],"thresholds":[201],"supported":[202],"overall":[205],"pattern.":[206],"CONCLUSION:":[207],"PCI,":[210],"observed":[214],"mainly":[219],"anticipated":[225],"rather":[228],"alone.":[233],"These":[234],"findings":[235],"support":[236],"strategy-based":[237],"risk":[239],"assessment":[240],"careful":[242],"donor-vessel":[243],"protection":[244],"when":[245],"retrograde":[246],"hybrid":[248],"crossing":[249],"expected.":[251]},"counts_by_year":[],"updated_date":"2026-09-27T08:07:27.782135","created_date":"2026-08-28T00:00:00"}