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Impact of complete revascularization with percutaneous coronary intervention on survival in patients with at least

Renato Valenti1, Angela Migliorini, Umberto Signorini

  • 1Division of Cardiology, Careggi Hospital, Viale Pieraccini, I-50134 Florence, Italy.

European Heart Journal
|August 7, 2008
PubMed

Insights

Successful drug-eluting stent percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) improves long-term cardiac survival. This survival benefit is most pronounced in patients with multivessel disease who achieve complete revascularization.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Chronic total occlusion (CTO) poses a significant challenge in coronary artery disease management.
  • Percutaneous coronary intervention (PCI) using drug-eluting stents (DES) is a primary revascularization strategy for CTO.
  • The long-term survival impact of successful CTO-PCI remains an area of active investigation.

Purpose of the Study:

  • To evaluate the effect of successful drug-eluting stent-supported PCI on long-term survival in patients with CTO.
  • To compare cardiac survival rates between successful and failed CTO-PCI procedures.
  • To identify patient subgroups benefiting most from successful CTO-PCI.

Main Methods:

  • Retrospective analysis of consecutive patients undergoing PCI for at least one CTO between 2003 and 2006.
  • Stratification of patients into successful (71%) and failure CTO-PCI groups.
  • Comparison of long-term cardiac survival, considering factors like multivessel disease and complete revascularization.

Main Results:

  • Successful CTO-PCI was achieved in 71% of patients and 68% of lesions.
  • Long-term cardiac survival was significantly higher in the successful CTO-PCI group (91.6%) compared to the failure group (87.4%; P = 0.025).
  • Patients with multivessel disease and complete revascularization in the success group showed superior survival rates (94.0%) versus incomplete revascularization (83.8%; P < 0.001).

Conclusions:

  • Successful drug-eluting stent-supported CTO-PCI significantly improves long-term cardiac survival.
  • The survival benefit is particularly evident in patients with multivessel disease who undergo complete revascularization.
  • CTO-PCI success is a critical determinant of favorable long-term outcomes in selected patient populations.
Abstract

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