Study Looks at Temporal Trends of PCI for CTO in Europe
October 9, 2018—Findings from an investigation of temporal trends in chronic total occlusion (CTO) interventions in Europe were published online by Nikolaos V. Konstantinidis, MD, et al on behalf of the Euro CTO Club in Circulation: Cardiovascular Interventions. The study focused on the evolution of practice, procedural outcomes, and in-hospital complications of percutaneous coronary intervention (PCI) to treat CTOs in Europe.
The study assessed data from 17,626 procedures that were included in the European registry between January 2008 and June 2015. The mean patient age was 63.9 ± 10.9 years and 85% were men.
In Circulation: Cardiovascular Interventions, the investigators reported that through the study period:
- Procedural success increased from 79.7% to 89.3%.
- Patients had increasing comorbidities and lesion complexity, with an increase in J-CTO score [Multicenter CTO Registry of Japan] from 1.76 ± 1.03 in 2008 to 2.17 ± 0.91 in 2015 (P for trend < .001).
- Retrograde approach utilization steadily increased from 10.1% in 2008 to 29.9% in 2015 (P for trend < .001).
- Antegrade dissection reentry adoption was low, not exceeding 5.5%.
- In-hospital mortality decreased from 0.4% to 0.1% (P for trend < .001).
- In-hospital complication rates remained essentially unchanged in the range 4.4% to 5.2% (P for trend = .39).
The investigators concluded that CTO PCI has shown a steady increase in the procedural success rate over time, with unchanged complication rates, despite the increasing complexity of the lesions treated. The J-CTO score predictive value for procedural success was low for the entire registry and had no predictive ability for the retrograde approach, noted the investigators in Circulation: Cardiovascular Interventions.