Related Experiment Video
Updated: Jun 25, 2025
Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
The outcomes and complications of percutaneous interventions in chronic total coronary occlusion
Muhammad Suleman1,2, Nayyar Arif1, Muhammad Ishaq Khan2
1Department of Cardiology, Armed Forces Institute of Cardiology, Rawalpindi, Punjab, Pakistan.
Insights
This study found that chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in Pakistan has a high success rate (77.5%) and low complications (13.7%). Diabetes was linked to higher procedural failure rates.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Public Health
Background:
- Limited access to complex coronary intervention facilities and skilled operators in Pakistan due to high costs and skill shortages.
- A scarcity of capable medical centers for chronic total occlusion percutaneous coronary intervention (CTO PCI).
Purpose of the Study:
- To examine the outcomes and potential complications of CTO PCI procedures.
- To assess the effectiveness of CTO PCI at a high-volume national institute in Pakistan.
Main Methods:
- Retrospective analysis of 306 patients undergoing CTO PCI over six months.
- Evaluation of procedural success, complication rates, and risk factors for failure.
- Analysis of patient demographics, target vessels, and procedural approaches (antegrade vs. retrograde).
Main Results:
- Successful re-vascularization in 77.5% of patients (237/306) with a 13.7% complication rate.
- The antegrade approach was used in 97.39% of cases, with the Right Coronary Artery (RCA) being the most common target.
- Diabetes was identified as the only significant risk factor associated with CTO PCI failure (30.43% vs. 30.43%, P=0.015).
Conclusions:
- CTO PCI can achieve excellent procedural success rates with low complication rates.
- CTO procedural failure is linked to a higher incidence of complications.
- Diabetes is a significant risk factor contributing to higher rates of CTO PCI procedural failure.
Background:
The limited availability of complex coronary intervention facilities and qualified operators, due to the high cost associated with chronic total occlusion (CTO) percutaneous intervention (PCI) equipment and a shortage of necessary skills, has led to a scarcity of capable medical centers in Pakistan. This study seeks to examine the outcomes and potential complications associated with CTO PCI procedures conducted at the Cardiac Catheterization Laboratories of a prominent national institute in Pakistan, which handles a large volume of cases.
Results:
Three hundred and six patients were included in the study in the study period of six months. The mean age was 59.49 (± 9.16) years: 256 (83.66%) were male and 50 (16.34%) were female. CTO was successfully re-vascularized in 237 (77.5%) with a complication rate of 13.7%. Two hundred and ninety-eight (97.39%) patients underwent an antegrade approach, while RCA was the most common target vessel (47.71%). Diabetes was the only significant associated risk factor with CTO PCI failure (30.43% vs. 30.43%, P-value = 0.015).
Conclusion:
We achieved an excellent procedural success rate with a low complication rate. CTO procedural failure is associated with a higher complication rate, and diabetes is among the risk factors that lead to higher procedural failure.
Related Concept Videos
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:25Chronic Obstructive Pulmonary Disease-III: Symptoms and Complications.
Symptoms of COPD can be classified as primary or systemic. Primary symptoms relate to reduced airflow, while systemic or extrapulmonary symptoms relate to COPD's broader impact on the body.
Primary Symptoms of COPD: