Introduction There are limited data on the impact of successful chronic total occlusion (CTO) revascularisation by percutaneous coronary intervention (PCI) on long-term outcomes.

Methods Between June 1993 and December 2006, a total of 1332 patients having PCI for a CTO were consecutively registered. In addition to an assessment of procedural outcomes, patients were followed long-term for occurrence of major adverse cardiac events (MACE). A CTO was defined as an occlusion of the artery present for at least 3 months with Thrombolysis in Myocardial Infarction flow grade 0 or 1. Long-term survival rate was estimated by Kaplan-Meier methods.

Results The overall success rate was 90.2% (1202/1332). During a median follow-up of 6.26±2.52 years (median 6 years), the estimated 10-year survival rate was 76.7% in the CTO success patients and 65.5% in the CTO failure patients, respectively (p<0.001). The MACE-free survival rate was significantly higher for CTO success patients compared with CTO failure patients (48.0% vs. 33.0%, p<0.001). The rates of coronary artery bypass (CABG) were 4.3% vs. 14.6% (p<0.001) for the CTO success and CTO failure patients, respectively. Multivariate analysis showed that procedural failure, diabetes mellitus and multivessel disease were independent predictors of death.

Conclusions Successful revascularisation for CTO improves long-term survival and reduces MACE rate and the need for CABG compared with failed procedure.