Coronary Artery DiseaseMeta-Analysis of Clinical Outcomes of Patients Who Underwent Percutaneous Coronary Interventions for Chronic Total Occlusions
Section snippets
Methods
We performed a comprehensive search of the Pubmed and Cochrane Library databases for manuscripts on coronary CTOs using the following keywords: “chronic total occlusion,” “percutaneous coronary intervention,” “stent,” “drug-eluting stents,” and “angioplasty.” Initially, no language or time limitations were applied; however, only studies in English and French were included in our meta-analysis. The references of those studies were checked for additional relevant studies as were subsequent
Results
Of 163 publications retrieved through electronic search and reference checking, 25 observational studies12 were included in the final pooled analysis (Table 1, Figure 2). A total of 28,486 patients underwent 29,315 CTO PCI procedures: 20,778 were successful and 8,537 were unsuccessful, with no significant between-group differences in baseline demographics and risk factor profile. No randomized controlled trials were identified.
The baseline demographic and angiographic characteristics of the
Discussion
Our meta-analysis is the largest to date (including nearly twice as many patients as the largest previous one) comparing long-term outcomes after successful versus failed CTO PCI. Table 4 summarizes the main findings of the present meta-analysis compared with previous studies. The main finding was that successful CTO PCI is associated with improved clinical outcomes (mortality, MI, CABG, stroke, angina but not TVR), regardless of the revascularization technique used (balloon angioplasty, BMS,
Disclosures
Dr. Kumbhani: honoraria: American College of Cardiology, Somahlution; Dr. Vo: speaking fees and proctoring honoraria from Boston Scientific; Dr. Alaswad: consulting fees from Terumo, Asahi, and Boston Scientific; consultant, no financial, Abbott Laboratories; Dr. Karmpaliotis: honoraria from Abbott Vascular, Boston Scientific, Asahi, and Medtronic; Dr. Rinfret has received speaker and proctorship honoraria from Boston Scientific (BridgePoint Medical), Abbott Vascular Canada, Medtronic Canada,
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