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Successful Recanalization of Native Coronary Chronic Total Occlusion Is Not Associated With Improved Long-Term

Pil Hyung Lee1, Seung-Whan Lee1, Hee-Soon Park1

  • 1Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

JACC. Cardiovascular Interventions
|March 8, 2016
PubMed

Insights

Successful drug-eluting stent percutaneous coronary intervention (PCI) for coronary total occlusion (CTO) did not reduce mortality risk but significantly decreased the need for subsequent coronary artery bypass grafting.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • The prognostic impact of successfully opening chronic total occlusions (CTO) via percutaneous coronary intervention (PCI) remains unclear.
  • Evaluating long-term outcomes of drug-eluting stent (DES)-supported PCI for native coronary CTO is crucial.

Purpose of the Study:

  • To assess the long-term clinical outcomes following DES-supported PCI in patients with native coronary total occlusions (CTO).

Main Methods:

  • A cohort of 1,173 patients with native coronary CTO undergoing PCI between March 2003 and May 2014 were analyzed.
  • Drug-eluting stent implantation was performed in 1,004 patients (85.6%) with successful procedures.

Main Results:

  • After a median follow-up of 4.6 years, successful CTO-PCI did not significantly alter the risks of all-cause mortality or the composite of death/myocardial infarction compared to failed PCI.
  • However, successful CTO-PCI was associated with significantly lower risks of target vessel revascularization and coronary artery bypass grafting (CABG).
  • In patients with complete revascularization of non-CTO vessels, successful CTO recanalization did not impact the risk of death or death/myocardial infarction.

Conclusions:

  • Successful CTO-PCI is not associated with reduced mortality risk but significantly decreases the need for subsequent coronary artery bypass grafting.
  • These findings hold true for patients with multivessel disease including CTO and those with single CTO disease.
Abstract

Keywords:
chronic total occlusiondrug-eluting stentpercutaneous coronary interventionprognosis

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