Impact of lesion length on the outcomes of chronic total occlusion percutaneous coronary intervention: Insights from the PROGRESS‐CTO registry

Abstract

Background:The impact of occlusion length on the procedural techniques and outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study.

Long‐term clinical outcomes following successful percutaneous coronary intervention in patients with extremely long coronary chronic total occlusion lesions

“…[20][21][22] In addition, in the most recently reported multicenter study on the relationship between lesion length and clinical outcomes, the cut-off for the length of the lesion was set at 20 mm, and the study only reported the association between lesion length and in-hospital or periprocedural outcomes. 23 However, in this study, unlike the results of recent studies that evaluated the role of lesion length on clinical outcomes, the incidence of hard endpoints such as cardiac mortality and mortality were also found to be frequent in long lesions. In addition, we observed that a long lesion was an important independent predictor of overall 5-year adverse clinical outcomes, including cardiac mortality.…”

“…However, including our previous study, none of the studies on lesion length and long‐term prognosis of CTO can demonstrate a correlation between hard endpoints such as cardiac mortality and lesion length 20–22 . In addition, in the most recently reported multicenter study on the relationship between lesion length and clinical outcomes, the cut‐off for the length of the lesion was set at 20 mm, and the study only reported the association between lesion length and in‐hospital or periprocedural outcomes 23 . However, in this study, unlike the results of recent studies that evaluated the role of lesion length on clinical outcomes, the incidence of hard endpoints such as cardiac mortality and mortality were also found to be frequent in long lesions.…”

“…Furthermore, imaging studies such as intravascular ultrasound or optical coherence tomography were only used in a small proportion of patients (less than 30%); therefore, lesion length was mainly measured angiographically and also could affect periprocedural clinical outcomes. Finally, based on the results of our previous studies, 22–25 we set the cut‐off value for extremely long lesions as ≥50 mm. However, to identify a more accurate cut‐off value for extremely long lesions that predicts long‐term adverse clinical outcomes, including CD and mortality, further investigation and statistical methods are necessary in the future study with larger study population with recent intervention techniques and devices who underwent newer‐generation DESs implantation.…”

“…Furthermore, imaging studies such as intravascular ultrasound or optical coherence tomography were only used in a small proportion of patients (less than 30%); therefore, lesion length was mainly measured angiographically and also could affect periprocedural clinical outcomes. Finally, based on the results of our previous studies, [22][23][24][25] we set the cut-off value for extremely long lesions as ≥50 mm. However, to identify a more accurate cut-off value for extremely long lesions that predicts…”