Chronic total coronary artery occlusion recanalisation with percutaneous coronary intervention - Single centre 10-year experience

Coronary artery chronic total occlusions (CTO) are common - approximately one-third of patients with significant coronary artery disease on angiography have at least 1 CTO. Invasive treatment of these lesions still remain a major challenge for interventional cardiology due to their complexity. Historically, success rates have improved to about 60-70% by using only the traditional antegrade approach. The results have dramatically improved during the last decade after more widespread application of new retrograde techniques. The aim of our study was to review and analyse single hospital experience in CTO invasive treatment and to evaluate the long-term results. A total of 519 patients undergoing percutaneous coronary interventions (PCI) for CTO at a single tertiary PCI centre (Riga East University Hospital), were included in the study. The median age was 64 years (38-88), and 80% were male. The retrograde approach (RA) was used for 167 (32.2%) of the CTO PCI patients. The overall patient success rate was 81.3% and it increased from 73.9% in 2007 to 95.2% in 2015 (p < 0.001). Mean patient observation time was five years. Overall survival was found significantly better in patients group after successful CTO PCI procedures (Long-rank test, p = 0.013).