Related Experiment Video

Updated: May 9, 2026

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control
05:41

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control

Published on: December 16, 2022

Meta-analysis of the long term effects of different interventions on chronic total coronary occlusions

S-S Yang1, L Tang, G-H Ge

  • 1Department of Cardiology, Central Hospital, Fengxian District, Shanghai, China. yangss@medmail.com.cn

European Review for Medical and Pharmacological Sciences
|July 9, 2013
PubMed

Insights

Drug-eluting stents (DES) show better long-term outcomes for coronary chronic total occlusion (CTO) than bare metal stents (BMS) or percutaneous transluminal coronary angioplasty (PTCA). BMS implantation is superior to PTCA for CTO revascularization.

Area of Science:

  • Interventional Cardiology
  • Cardiovascular Research
  • Medical Technology Assessment

Background:

  • Coronary chronic total occlusion (CTO) represents advanced coronary artery atherosclerosis.
  • Revascularization options for CTO include percutaneous transluminal coronary angioplasty (PTCA), bare metal stents (BMS), and drug-eluting stents (DES).
  • Scientific evaluation of long-term outcomes for CTO interventional treatments is crucial.

Purpose of the Study:

  • To compare the long-term effectiveness of different CTO revascularization strategies.
  • To evaluate outcomes of PTCA versus BMS.
  • To assess long-term outcomes of BMS versus DES in CTO patients.

Main Methods:

  • Meta-analysis of relevant studies on long-term outcomes for CTO treatments.
  • Data extraction and assessment by two independent clinical experts.
  • Analysis of variables including mortality, re-occlusion, re-stenosis, target lesion revascularization (TLR), and major adverse cardiac events (MACE).

Main Results:

  • PTCA was associated with significantly higher rates of re-occlusion, re-stenosis, subsequent PTCA, and TLR compared to BMS.
  • In a comparison of 3605 CTO patients, BMS groups had significantly higher MACE, subsequent coronary artery bypass graft surgery (CABG), re-stenosis/re-occlusion rates, and TLR than DES groups.
  • BMS groups also showed a lower MACE-free survival rate compared to DES groups.

Conclusions:

  • BMS implantation resulted in significantly lower rates of re-occlusion, re-stenosis, subsequent PTCA, and TLR compared to PTCA procedures.
  • Compared to DES, BMS implantation was associated with higher rates of MACE, subsequent CABG, and re-stenosis/re-occlusion.
  • The MACE-free survival rate was lower in BMS groups than in DES groups, indicating superior long-term outcomes with DES.
Abstract

Related Concept Videos

Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
Coronary Artery Disease IV: Preventive Measures01:26

Coronary Artery Disease IV: Preventive Measures

Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
Angina IV: Management01:26

Angina IV: Management

IntroductionThe management of angina requires a comprehensive approach that includes pharmacological therapies, medical procedures, and lifestyle modifications.Pharmacological TherapiesAntiplatelet agents, such as aspirin, clopidogrel, prasugrel, and ticagrelor, play a pivotal role in preventing thrombus formation in patients with angina. These medications inhibit platelet aggregation and reduce the likelihood of myocardial infarction and other cardiovascular events.Anticoagulants, including...