Impact of complete revascularization with percutaneous coronary intervention on survival in patients with at least one chronic total occlusion

Renato Valenti, Angela Migliorini, Umberto Signorini, Ruben Vergara, Guido Parodi, Nazario Carrabba, Giampaolo Cerisano, and David Antoniucci*

Aims: This study sought to determine the impact on survival of successful drug-eluting stent-supported percutaneous coronary intervention (PCI) for chronic total occlusion (CTO).

Methods and results: Comparison of long-term cardiac survival of consecutive patients who underwent PCI for at least one CTO and who were stratified into successful and failure procedures. From 2003 to 2006, 486 patients underwent PCI for 527 CTO. CTO–PCI was successful in 344 patients (71%) and 361 lesions (68%). Multivessel PCI was performed in 62% in the CTO–PCI failure group and in 71% in the CTO–PCI success group (P . 0.062). Cardiac survival rate was higher in the CTO–PCI success group compared with CTO–PCI failure group (91.6+2.0 vs. 87.4+2.9%; P . 0.025), in patients with multivessel disease and CTO–PCI success compared with CTO–PCI failure (91.4+2.2 vs. 86.6+3.1%; P . 0.021), and in patients with complete revascularization when compared to patients with incomplete revascularization (94.0+1.7 vs. 83.8+3.6%; P , 0.001).

Conclusion: Successful CTO–PCI confers a long-term survival benefit. Improvement in survival is driven by the differences in the outcome of patients with multivessel disease and who were completely revascularized.

Keywords Percutaneous coronary intervention † Chronic total occlusion † Drug-eluting stent

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