Indications, Management, and Short- and Medium-Term Outcomes of Patients with Chronic Coronary Occlusion Treated with Percutaneous Revascularization—A Single-Center Study

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Chronic total occlusion of coronary artery (n=41). Intervention: Percutaneous coronary intervention (PCI). Primary outcome: Procedural success (TIMI grade ≥2 antegrade flow in all distal branches ≥2.5 mm and residual stenosis <30%).

Lucia Barbieri; Gabriele Tumminello; Lorenzo Mafrici; Guido Pasero; Luca Mircoli; Federico Colombo; Cecilia Gobbi; Alessandra Stefania Rizzuto; Stefano Carugo

doi:10.3390/jcdd12020075

February 16, 2025Journal of Cardiovascular Development and DiseaseOpen Access

Indications, Management, and Short- and Medium-Term Outcomes of Patients with Chronic Coronary Occlusion Treated with Percutaneous Revascularization—A Single-Center Study

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Key result

Percutaneous coronary intervention for chronic total occlusion achieved an 80.5% procedural success rate and a 9.8% major complication rate.

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Why the study?

Indications for performing CTO recanalization procedures do not originate from randomized controlled trials.

Study Design

Type

Cohort (n=41)

Multicenter

No

Structured PICO

P

Population

41 patients with chronic total coronary occlusions who underwent percutaneous revascularization, followed for a median of 449 days.

E

Exposure

Percutaneous coronary intervention (PCI) for CTO recanalization

O

Outcome

Procedural outcomes including procedural success (TIMI grade ≥ 2 for antegrade flow and residual stenosis < 30% at the site of occlusion) and procedural complicationscomposite

PCI for chronic total occlusions in a real-world single-center cohort demonstrated an 80.5% success rate and significantly reduced angina symptoms in successfully recanalized symptomatic patients.

Limitations

Single-center study with a small sample size
Observational and retrospective nature may have introduced selection bias
Inability to retrieve all potentially relevant data or compare outcomes with a conservatively treated CTO population
Restricted evaluation period limited to the last three years
Observational and retrospective nature introducing selection bias
Inability to retrieve all potentially relevant data or to compare outcomes with a conservatively treated population
Small number of patients in the drug-eluting balloon subgroup preventing ad hoc analyses

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Implication

These single-center outcomes should not yet change practice; leaves open comparative efficacy versus medical therapy in randomized trials.

Abstract

The diagnosis of chronic total occlusion (CTO), characterized by the complete obstruction of a coronary artery for at least three months, remains challenging and can be entirely asymptomatic. Since the indications for performing a recanalization procedure for CTO do not originate from randomized controlled trials, this study aimed to assess the indications, management, and procedural outcomes of patients undergoing percutaneous revascularization (PCI) for a CTO, ensuring that the population was as uniform as possible regarding technologies and methodological approaches. Forty-one consecutive patients who underwent PCI for CTO recanalization were enrolled from January 2021 to 2024. Additional outcomes included mortality, major adverse cardiovascular events, and the presence of residual cardiac symptoms, with a median follow-up of 449 days and an interquartile range of 230-643 days. Our real-life study confirmed that PCI for CTO has a high success rate and a low incidence of major complications.

Discussion

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Cite This Study

Barbieri et al. (2025) conducted a cohort in Chronic total occlusion of coronary artery (n=41). Percutaneous coronary intervention (PCI) was evaluated on Procedural success (TIMI grade ≥2 antegrade flow in all distal branches ≥2.5 mm and residual stenosis <30%). Percutaneous coronary intervention for chronic total occlusion achieved an 80.5% procedural success rate and a 9.8% major complication rate.

synapsesocial.com/papers/6a50398373bacd73dc7844e7 https://doi.org/10.3390/jcdd12020075

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Indications, Management, and Short- and Medium-Term Outcomes of Patients with Chronic Coronary Occlusion Treated with Percutaneous Revascularization—A Single-Center Study

Figures

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Indications, Management, and Short- and Medium-Term Outcomes of Patients with Chronic Coronary Occlusion Treated with Percutaneous Revascularization—A Single-Center Study

Figures

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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