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Percutaneous coronary intervention for chronic total occlusions: improved survival for patients with successful

Shahid Aziz1, Rodney H Stables, Antony D Grayson

  • 1Department of Cardiology, Royal Blackburn Hospital, Blackburn, Lancashire, United Kingdom. saziz1@bitinternet.com

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|June 21, 2007
PubMed

Insights

Successful chronic total occlusion (CTO) revascularization via percutaneous coronary intervention (PCI) significantly improves patient survival. Failed CTO procedures are linked to higher mortality rates, highlighting the importance of successful revascularization.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Limited data exists on the survival impact of successful chronic total occlusion (CTO) revascularization using percutaneous coronary intervention (PCI).
  • This study retrospectively compares survival outcomes between patients with successful and failed CTO revascularization.
  • CTO is defined as an arterial occlusion present for at least 3 months with Thrombolysis in Myocardial Infarction (TIMI) flow grade 0 or 1.

Purpose of the Study:

  • To evaluate the effect of successful CTO revascularization by PCI on patient survival.
  • To compare mortality rates between patients who underwent successful versus failed CTO PCI procedures.
  • To identify CTO failure as an independent predictor of mortality.

Main Methods:

  • Retrospective analysis of 543 patients undergoing PCI for CTO between 2000 and 2004.
  • Patient records were linked to a national database for mortality tracking.
  • Propensity matching was employed to control for case mix differences between successful and failed CTO groups.

Main Results:

  • Technical success rate for CTO PCI was 69.4% (377/543 patients).
  • Mortality rates were significantly lower in the successful CTO PCI group (2.5% vs. 7.3% at 1.7 years follow-up).
  • CTO failure was an independent predictor of death (adjusted hazard ratio 4.63).

Conclusions:

  • Successful revascularization of CTO by PCI is associated with improved survival rates.
  • Failed CTO PCI procedures are linked to a significantly higher risk of mortality.
  • Achieving successful CTO revascularization is crucial for enhancing long-term patient outcomes.
Abstract

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