Adaptation of a language awareness test : a focus of cognitive-linguistic and cultural factors in predicting reading development

The present study describes the process of adapting the Norwegian “Ringerike Materialet” Language Awareness Screening Tool (Lyster and Tingleff, 1992) to Hungarian. Forty-two kindergarten children were tested with the material, which in addition to language awareness abilities had measures of verbal short term memory, listening comprehension, and letter knowledge as extra tasks. Fifty-eight first graders were tested with the tasks, plus nonverbal IQ, rapid naming and reading after tree months of reading instruction. A cross- sectional comparative and correlational- predictive part were conceptualized in the process of mapping Hungarian children’s metalinguistic abilities by this battery and to examine factors accounting for early reading performances in Hungarian, a transparent orthography with a clear grapheme- phoneme correspondence. The comparative part proved a clear developmental progress in children’s linguistic abilities. The correlational part gave evidence about inter- correlations between the cognitive and linguistic variables measuring the underlying construct of language awareness as a preliminary demonstration that the awareness of large units of the language may bear a close relationship to reading development in this transparent language. The predictive part of the present study additionally gave more specific information about which cognitive- linguistic factors predicted the growth in reading. The findings supported the relevancy of language awareness theory in the process of learning to read. Phonological, morphological, grammatical awareness as well as broad linguistic skills presented a large contribution to reading after controlling for the effect of intelligence and letter knowledge. An interesting finding was the sensibility of rhyme awareness in predicting reading development in Hungarian. Short term memory and rapid naming did not uniquely predict reading if IQ and letter knowledge were controlled, but were related to reading performances. The contribution of morphological and grammatical awareness was explained by the complexity of the language. Additionally this work describes the method of teaching reading and the effect of home environment on Hungarian children’s literacy development in Transylvania

TCT-126 Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention of the Left Anterior Descending Artery

Background: Improvement of left ventricular ejection fraction (LVEF) after chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has been modest in prior studies. Methods: Our cohort included patients who underwent LAD CTO PCI at a single center (Henry Ford Hospital) from 2014 to 2021. We evaluate the change in LVEF after LAD CTO PCI using the paired t test in all patients, those with ischemic cardiomyopathy (CM), and those who underwent a viability test. Results: From December 2014 to February 2022, a total of 237 LAD CTO PCI procedures were performed at Henry Ford Hospital (proximal LAD: 56.6%). In-hospital MACE occurred in 13 patients (5.5%; death: 1.3%). Landmark analysis after discharge showed an overall survival of the cohort was 92.7% and MACE-free survival of 85.0% over a median follow-up of 2 years. The median baseline EF was 50% (IQR 35%-55%). Only 51 patients had reduced baseline LVEF (40% or less). After a median follow-up of 9.2 months (IQR 3-28.6 months), there was a significant improvement in LVEF after LAD CTO PCI (mean 10.9%, 95% CI 7.1%-14.8%, P \u3c 0.001). When limiting the analysis to patients who had ischemic cardiomyopathy, proximal LAD CTO PCI, and were on optimal medical therapy (n = 29), LVEF was significantly improved (mean increase of 14%, 95% CI 9.5-18.5%, P \u3c 0.001) after a median follow-up period of 6.2 months (3-29.5 months). Conclusion: LAD CTO PCI was associated with a significant 10% improvement in LVEF in ICM patients and was more pronounced (14% improvement) in those who had proximal LAD treated and were on optimal medical therapy. Categories: CORONARY: Complex and Higher Risk Procedures for Indicated Patients (CHIP

Laser for balloon uncrossable and undilatable chronic total occlusion interventions

BACKGROUND: There is limited information on use of laser in complex percutaneous coronary interventions (PCI). We examined the impact of laser on the outcomes of balloon uncrossable and balloon undilatable chronic total occlusion (CTO) PCI. METHODS: We reviewed baseline clinical and angiographic characteristics and procedural outcomes of 4845 CTO PCIs performed between 2012 and 2020 at 32 centers. RESULTS: Of the 4845 CTO lesions, 752 (15.5%) were balloon uncrossable (523 cases) or balloon undilatable (356 cases) and were included in this analysis. Mean patient age was 66.9 ± 10 years and 83% were men. Laser was used in 20.3% of the lesions. Compared with cases in which laser was not used, laser was more commonly used in longer length occlusions (33 [21, 50] vs. 25 [15, 40] mm, p = 0.0004) and in-stent restenotic lesions (41% vs. 20%, p \u3c 0.0001). Laser use was associated with higher technical (91.5% vs. 83.1%, p = 0.010) and procedural (88.9% vs. 81.6%, p = 0.033) success rates and similar incidence of major adverse cardiac events (3.92% vs. 3.51%, p = 0.805). Laser use was associated with longer procedural (169 [109, 231] vs. 130 [87, 199], p \u3c 0.0001) and fluoroscopy time (64 [40, 94] vs. 50 [31, 81], p = 0.003). CONCLUSIONS: In a contemporary, multicenter registry balloon uncrossable and balloon undilatable lesions represented 15.5% of all CTO PCIs. Laser was used in approximately one-fifth of these cases and was associated with high technical and procedural success and similar major complication rates

Percutaneous coronary intervention of chronic total occlusions involving a bifurcation: Insights from the PROGRESS-CTO registry

BACKGROUND: The impact of bifurcations at the proximal or distal cap on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. METHODS: We analyzed the clinical, angiographic, and procedural data of 4,584 cases performed in patients between 2012 and 2020 in a global CTO PCI registry. We compared 4 groups according to the bifurcation location: proximal cap, distal cap, proximal and distal cap, and no bifurcation. RESULTS: The CTO involved a bifurcation in 67% cases, as follows: proximal cap (n = 1451, 33%), distal cap (n = 622, 14%), or both caps (n = 954, 21%). Proximal and distal cap cases had higher J-CTO compared with proximal cap, distal cap, and no bifurcation cases (2.9 ± 1.1 vs 2.5 ± 1.1 vs 2.4 ± 1.2 vs 2.0 ± 1.2, P \u3c 0.0001), and they were also associated with a lower technical success rate (79% vs 85% vs 85% vs 90%, P \u3c 0.0001), higher pericardiocentesis rate (1% vs 1% vs 0.2% vs 0.3%, P = 0.02), and higher emergency coronary artery bypass graft surgery rate (0.3% vs 0% vs 0% vs 0%, P = 0.01). CONCLUSION: More than two-thirds of CTO PCIs involve a bifurcation, which is associated with lower technical success and higher risk of complications

Angiographic Features and Clinical Outcomes of Balloon Uncrossable Lesions during Chronic Total Occlusion Percutaneous Coronary Intervention

Background: Balloon uncrossable lesions are defined as lesions that cannot be crossed with a balloon after successful guidewire crossing. Methods: We analyzed the association between balloon uncrossable lesions and procedural outcomes of 8671 chronic total occlusions (CTOs) percutaneous coronary interventions (PCIs) performed between 2012 and 2022 at 41 centers. Results: The prevalence of balloon uncrossable lesions was 9.2%. The mean patient age was 64.2 ± 10 years and 80% were men. Patients with balloon uncrossable lesions were older (67.3 ± 9 vs. 63.9 ± 10, p < 0.001) and more likely to have prior coronary artery bypass graft surgery (40% vs. 25%, p < 0.001) and diabetes mellitus (50% vs. 42%, p < 0.001) compared with patients who had balloon crossable lesions. In-stent restenosis (23% vs. 16%. p < 0.001), moderate/severe calcification (68% vs. 40%, p < 0.001), and moderate/severe proximal vessel tortuosity (36% vs. 25%, p < 0.001) were more common in balloon uncrossable lesions. Procedure time (132 (90, 197) vs. 109 (71, 160) min, p < 0.001) was longer and the air kerma radiation dose (2.55 (1.41, 4.23) vs. 1.97 (1.10, 3.40) min, p < 0.001) was higher in balloon uncrossable lesions, while these lesions displayed lower technical (91% vs. 99%, p < 0.001) and procedural (88% vs. 96%, p < 0.001) success rates and higher major adverse cardiac event (MACE) rates (3.14% vs. 1.49%, p < 0.001). Several techniques were required for balloon uncrossable lesions. Conclusion: In a contemporary, multicenter registry, 9.2% of the successfully crossed CTOs were initially balloon uncrossable. Balloon uncrossable lesions exhibited lower technical and procedural success rates and a higher risk of complications compared with balloon crossable lesions

Use of the Limited Antegrade Subintimal Tracking Technique in Chronic Total Occlusion Percutaneous Coronary Intervention

BACKGROUND There are limited data on the limited antegrade subintimal tracking (LAST) technique for chronic total occlusion (CTO) percutaneous coronary intervention (PCI).OBJECTIVES The aim of this study was to analyze the frequency of use and outcomes of the LAST technique for CTO PCI.METHODS We analyzed 2,177 CTO PCIs performed using antegrade dissection and re-entry (ADR) in the PROGRESS-CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) registry between 2012 and January 2022 at 39 centers. ADR was attempted in 1,465 cases (67.3%).RESULTS Among antegrade re-entry cases, LAST was used in 163 (11.1%) (primary LAST in 127 [8.7%] and secondary LAST [LAST after other ADR approaches failed] in 36 [2.5%]), the Stingray system (Boston Scientific) in 980 (66.9%), subintimal tracking and re-entry in 387 (26.4%), and contrast-guided subintimal tracking and re-entry in 29 (2.0%). The mean patient age was 65.2 similar to 10 years, and 85.8% were men. There was no significant difference in technical (71.8% vs 77.8%; P 1/4 0.080) and procedural (69.9% vs 75.3%; P 1/4 0.127) success and major cardiac adverse events (1.84% vs 3.53%; P 1/4 0.254) between LAST and non-LAST cases. However, on multivariable analysis, the use of LAST was associated with lower procedural success (OR: 0.61; 95% CI: 0.41-0.91). Primary LAST was associated with higher technical (76.4% vs 55.6%; P 1/4 0.014) and procedural (75.6% vs 50.0%; P 1/4 0.003) success and similar major adverse cardiac event (1.57% vs 2.78%; P 1/4 0.636) rates compared with secondary LAST.CONCLUSIONS LAST was used in 11.1% of antegrade re-entry CTO PCI cases and was associated with lower procedural success on multivariable analysis, suggesting a limited role of LAST in contemporary CTO PCI. (J Am Coll Cardiol Intv 2022;15:2284-2293) (c) 2022 by the American College of Cardiology Foundation

TCT-128 Saphenous Vein Graft Occlusion Following Native Vessel Chronic Total Occlusion Percutaneous Coronary Intervention

Background: The practice of occluding patent saphenous vein grafts (SVGs) after successful chronic total occlusion (CTO) percutaneous coronary intervention (PCI) of the native vessel has received limited study. Methods: We analyzed baseline clinical and angiographic characteristics and procedural outcomes of 51 patients who following successful CTO PCI of the native vessel underwent attempted SVG occlusion between 2015 and 2022 at 14 centers. Results: Mean patient age was 71 ± 8 years and 80% were men. The most common CTO target vessel was the right coronary artery (41%), followed by the left circumflex artery (35%). Retrograde crossing was the successful crossing strategy in 78% (n = 40) and the SVG was the collateral used for all the retrograde cases. Recurrent SVG failure (51%) was the most common reason for treating the native vessel instead of the SVG supplying the same vessel. Coils were used in 71% (n = 36) to occlude the SVG with a mean number of 1.9 ± 1.1 coils, and Amplatzer vascular plugs were used in 29% (n = 15) of the cases. All procedures were technically successful and the SVG was occluded completely (TIMI 0 flow) in 75% (n = 38) of the cases. Follow up was available for 38 patients (75%): during a mean follow up of 312 days, the incidence of target lesion failure was 5.4% (n = 2). There were no other associated periprocedural or in-hospital complications. Conclusion: SVG occlusion after successful native vessel CTO PCI, is associated with favorable periprocedural and mid-term outcomes. Categories: CORONARY: Complex and Higher Risk Procedures for Indicated Patients (CHIP