Multiple Versus Single Vessel CTO PCI in the Same Hospitalization: Data From the PROGRESS-CTO Registry.

Area of Science:

• Cardiology
• Interventional Cardiology

Background:

• Percutaneous coronary intervention (PCI) for multiple chronic total occlusions (CTOs) in a single procedure is uncommon and lacks extensive research.
• Understanding the safety and efficacy of multi-CTO PCI is crucial for optimizing treatment strategies.

Purpose of the Study:

• To compare the characteristics and outcomes of patients undergoing single versus multiple CTO PCIs during the same procedure.
• To evaluate the safety and resource utilization of multi-CTO PCI compared to single CTO PCI.

Main Methods:

• Analysis of a large, multicenter registry data from 16,550 patients undergoing 16,876 CTO PCIs.
• Comparison of patient demographics, lesion complexity (using PROGRESS-CTO and J-CTO scores), procedural success rates, and major adverse cardiovascular events (MACE).

Main Results:

• Patients undergoing multiple CTO PCI had similar technical and procedural success rates compared to single CTO PCI.
• Multi-CTO PCI required longer procedure/fluoroscopy times, higher contrast volume, and increased use of percutaneous ventricular assistance devices (pVAD).
• The incidence of MACE was comparable between single and multiple CTO PCI groups.

Conclusions:

• Attempting PCI of multiple CTOs in a single session is feasible and associated with similar clinical outcomes as single CTO PCI.
• Multi-CTO PCI necessitates increased procedural resources and support, including radiation, contrast, and pVAD.