Initial and long‐term results of percutaneous transluminal balloon angioplasty for chronic total occlusions: an analysis of 184 procedures

Abstract

The success rate for angioplasty of chronic total occlusions is acceptable. Long-term clinical benefit in patients with successful angioplasty is suggested by the high freedom from angina and the lesser need for coronary surgery. No major impact on either the incidence of MI or cardiac survival was noted when patients who had coronary surgery were included, although it must be emphasised that the sample size in this study was insufficient to detect a difference in these outcome variables.

Effects of percutaneous revascularization of chronic total occlusions on clinical outcomes: A meta‐analysis comparing successful versus failed percutaneous intervention for chronic total occlusion

“…We were able to find 23 observational studies comparing the desired clinical parameters between successful CTO recanalization and a strategy of medical management as a result of attempted but failed PCI . Of those, only two studies included a small number of patients (total of 27) who received pure medical management as PCI was not attempted due to unsuitable angiographic features.…”

“…). Long‐term MACE was reported or calculated for 19 studies . Successful percutaneous CTO recanalization reduced the overall risk of MACE with an RR of 0.704, 95% CI (0.595–0.832) with a P ‐value < 0.001(Fig.…”

“…Based on the comparison of hard end points between patients who underwent percutaneous CTO recanalization versus those treated with medical management (as a result of failed PCI), studies have shown conflicting results . This issue of the comparison of medical management versus PCI revascularization for the treatment of CTO is further complicated by the fact that no RCT has been conducted to evaluate the effects of CTO opening on clinical endpoints.…”

Noninvasive Coronary Artery Imaging: Current Clinical Applications

“…Success rates are poor [76,77] due to failure to cross the lesion with guide-wires [78]. The operator sometimes does not know the length of the occlusion, the course of the occluded vessel or the extent of calcification.…”

Percutaneous revascularization of chronic total occlusions: Review of the role of invasive and non-invasive imaging modalities

“…Despite rapid advances in the technology and experience of PCI, the success rate of PCI of CTO remains about 60-80% in comparison with the success rates of more than 90% in non-CTO PCIs [2][3][4][5][6]. The overwhelming majority of unsuccessful PCIs of CTO are due to failure in crossing the occluded lesion with angioplasty guide-wires [7].…”