PROGRESS-CTO International Registry Finds Increasing Procedural Success in CTO PCI

May 20, 2022—A new analysis was presented from PROGRESS-CTO, the Prospective Global Registry for the Study of Chronic Total Occlusion Intervention, which is an international multicenter registry of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). The registry is led by investigators at the Minneapolis Heart Institute Foundation (MHIF) in Minneapolis, Minnesota. The website is www.progresscto.org.

The PROGRESS-CTO analysis examined the clinical and angiographic characteristics and procedural outcomes of 10,249 CTO PCIs performed on 10,019 patients at 40 centers in the United States and outside the United States between 2012 and 2022.

The Society for Cardiovascular Angiography & Interventions (SCAI) announced that the findings show an increase in the success and efficiency of CTO PCI without an increase in major adverse cardiac events (MACE). The data were presented as late-breaking clinical research at the SCAI 2022 scientific sessions held May 19-22 in Atlanta, Georgia.

According to SCAI, the findings include:

• Low incidence (2.1%) of in-hospital MACE without significant changes over time
• High prevalence of previous PCI (62%), previous coronary artery bypass graft surgery (29%), and diabetes mellitus (43%) among registry participants
• High technical success (86%), which increased from 81.6% in 2016 to 88.1% in 2021
• Most common target vessels: right coronary artery (53%); left anterior descending artery (26%); left circumflex artery (19%)
• Target CTOs were highly complex: mean J-CTO score of 2.4 ±1.3; PROGRESS-CTO score of 1.3 ±1.0

The investigators advised that there is a need for increased operator training to better serve the large number of patients in need of CTO PCI, noted the SCAI press release.

Spyridon Kostantinis, MD, the PROGRESS-CTO Lead Investigator, who is Research Scholar at the Center for Coronary Artery Disease at MHIF, commented in the SCAI press release, “CTO PCI is a rapidly evolving technique in interventional cardiology to help treat patients with chronic total occlusion. The PROGRESS-CTO registry offers an opportunity to expand our global knowledge on this treatment option and further build on innovative techniques.”

Emmanouil Brilakis, MD, who is Chairman, Center for Coronary Artery Disease at MHIF, added, “Initially, there was a hesitancy towards CTO PCI because of concerns of low success and high complication rates. Our registry analysis demonstrates that the opposite is true—higher success rates combined with a low risk of adverse events which can be attributed to increased operator training and real-world experience.”

Finally, Bavana V. Rangan, BDS, MPH, Program Director at the Center for Coronary Artery Disease at MHIF, stated, “The registry contributes to the knowledge base for CTO PCI operators and provides first-hand insights to support physicians training for CTO PCI, which we hope will ultimately increase access to this critical procedure for patients.”