Research Fellow, Coronary Artery Disease Science Center Minneapolis Heart Institute Foundation Minneapolis, Minnesota
Background: Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention (CTO PCI) according to target vessel have received limited study.
Methods: We compared clinical, angiographic, procedural characteristics and outcomes of 1,568 right coronary artery (RCA), left anterior descending artery (LAD) and Left Circumflex (LCX) CTO PCIs with follow-up outcomes available.
Results: Mid RCA was the most common target vessel (Figure-Panel A). The J-CTO score was 2 [1,3] vs 3 [2,4] vs 3 [2,4], p<0.0001 (LAD vs LCX vs RCA respectively). Technical success was lower in RCA (89% vs 85% vs 84%, p=0.05). In-hospital MACE did not differ significantly (2.7% vs 4.8% vs 2.9%, p=0.3). Ιncidence of the composite of death, myocardial infarction (MI) and revascularization rates at 1 year were also similar (Figure-Panel B) (plog-rank=0.16). There was a numerical trend towards higher revascularization rates in the circumflex group (14%) vs 9% in LAD and 9% in the RCA group (p=0.2).
Conclusion: There is a trend for higher in-hospital MACE rates in circumflex lesions, but 1-year outcomes do not differ significantly according to target vessel.