Does PCI for Chronic Total Occlusions Confer a Survival Benefit?

Perhaps, if the occlusion is in the left anterior descending artery — but only a randomized trial can provide a definitive answer.

Controversy surrounds the survival benefit that was associated in some studies with percutaneous coronary intervention for chronic total occlusions (CTOs). In this single-center, observational study, investigators reviewed 2608 PCI procedures performed between June 1980 and May 2004 in patients with CTO (about 8% of PCI procedures during this time). Patients with acute MI (within 7 days before PCI) were excluded. Outcome analysis was stratified by the vessel treated: left anterior descending (LAD; 36%), left circumflex (LCX; 26%), or right coronary artery (RCA; 38%). About 60% of patients had severe angina. Mean LV ejection fraction was 37% in patients with LAD lesions and in those with LCX lesions, and 40% in patients with RCA lesions.

Angi…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI