Survival after percutaneous coronary intervention for chronic total occlusion

Abstract

Successful CTO recanalization is an independent predictor for improved long-term survival. Persistent CTO lesions are associated with significantly worse survival than persistent non-occlusive coronary lesions.

Long‐term clinical outcomes of successful revascularization with drug‐eluting stents for chronic total occlusions: A systematic review and meta‐analysis

“…Although no randomized controlled clinical trials have examined the long‐term clinical outcomes of patients with successful CTO‐PCI using drug‐eluting stents (DESs) compared with that with failed CTO‐PCI, a number of observational studies have examined this difference . However, the results of these studies were inconclusive and even contradictory.…”

Complete versus incomplete revascularization with drug‐eluting stents for multi‐vessel disease in stable, unstable angina or non‐ST‐segment elevation myocardial infarction: A meta‐analysis

“…Second, when the study that included STEMI (<20%) patients in their cohort, the result did not significantly change. Third, when studies that included BMS (<20%) were removed, all the clinical outcomes demonstrated similar results. Lastly, when studies included single vessel disease (<20%), the results remained consistent for every outcomes.…”

“…From 14 studies, 16 522 CR (39.6%) and 25 165 IR (60.4%) patients were included. STEMI was included in 10.7% of study from Valenti et al, and 12.6% within 24 h in study by Tamburino et al MVD < 20% was reported in 3 studies, whereas DES < 20% was described in 5 studies . Study results by Wu et al and Hannon et al were reported from the same registry.…”

To complete, or not to complete, that is the question of revascularization in percutaneous coronary intervention with drug-eluting stents for multivessel disease

“…In 3 (11,13,16) of the 5 studies, C-RV was associated with reduced R-RV. In 8 (6,9-11,13-16) of the 11 studies, C-RV was associated with reduced MAC(C)E. There were a number of important issues, however, in the aforementioned studies (1,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17) of C-RV versus IC-RV in DES-PCI for MV-CAD (except for AMI) (Figure 1). First, "angiographic" (successful angioplasty of all diseased lesions in the major epicardial coronary vessels and their first degree side branches) and "proximal" C-RV definitions (successful angioplasty of all diseased proximal arteries) according to a study by Kim et al (18) are more accurate and clinically relevant.…”

“…Our systematic search using keywords including "complete" or "completeness"; "incomplete" or "culprit"; "revascularization"; and "drug-eluting" identified 14 studies (1,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17) summarized in Tables 1,2. The design of all studies was a non-randomized observational study, and all but one (13) studies reported adjusted HRs for outcomes of interest in "C-RV vs. IC-RV" or "IC-RV vs. C-RV".…”