TCT-444 Chronic Total Occlusion Lesion Revascularization Alone versus Complete Revascularization in Chronic Total Occlusion Patients with Multivessel Disease
- 1 Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea, Republic of
Background
Chronic total occlusion (CTO) intervention is still challenging because of the limited procedural success rate and higher recurrence. It is not clear whether the complete revascularization will significantly impact on angiographic and clinical outcomes of CTO patients (pts) with multivessel disease (MVD).
Methods
A total of 138 consecutive CTO pts with MVD were divided into two groups; complete revascularization (CR, n=82) and CTO alone revascularization (CTO Alone, n=54) groups. Six-month angiographic and twelve-month clinical outcomes were compared between the two groups.
Results
The baseline clinical characteristics were balanced between the two groups except higher incidence of hypertension (73.8 vs. 57.3 p=0.035) and a lower incidence of Prior PTCA (12.5 vs. 34.4 p=0.001) in the CR group. The overall procedural success rate, procedural characteristics and procedure related complications associated with CTO were not different between the two groups. Angiographic outcomes at 6 months were not different. There was a trend toward higher incidence of target lesion revascularization (TLR)-major adverse cardiac events (MACE) in the CR group, predominatly due to higher incidence of TLR and repeat PCI 24 months as compared with CTO alone group (Table).
Conclusions
CR strategy in CTO pts with MVD failed to show the clinical benefit up to 24 months as compared with CTO alone revascularization. This is a hypothesis generating result and randomized study with larger study population will be necessary to get final conclusion.
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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