Original Research

DOI: 10.4244/EIJ-D-23-00490

Contemporary outcomes of chronic total occlusion percutaneous coronary intervention in Europe: the ERCTO registry

Giuseppe Vadalà1, MD; Alfredo R. Galassi2, MD; Gerald S. Werner3, MD, PhD; George Sianos4, MD; Nicolaus Boudou5, MD; Roberto Garbo6, MD; Laura Maniscalco1, PhD; Alexander Bufe7, MD; Alexander Avran8, MD; Gabriele L. Gasparini9, MD; Eugenio La Scala10, MD; Andrew Ladwiniec11, MD; Meruzhan Saghatelyan12, MD; Omer Goktekin13, MD, PhD; Sevket Gorgulu14, MD; Nicolaus Reifart15, MD, PhD; Pierfrancesco Agostoni16, MD; Sudhir Rathore17, MD; Mohamed Ayoub18, MD; Michael Behnes19, MD; Iskander Atmowihardjo20, MD; Mario Iannaccone21, MD; Roberto Diletti22, MD; Carlo Di Mario23, MD, PhD; Kambis Mashayekhi24,25, MD, PhD; on behalf of the EURO CTO investigators


BACKGROUND: Percutaneous coronary interventions (PCI) of chronic total occlusions (CTO) have reached high procedural success rates thanks to dedicated equipment, evolving techniques, and worldwide adoption of state-of-the-art crossing algorithms.

AIMS: We report the contemporary results of CTO PCIs performed by a large European community of experienced interventionalists. Furthermore, we investigated the impact of different risk factors for procedural major adverse cardiac and cerebrovascular events (MACCE) and trends of employment of specific devices like dual lumen microcatheters, guiding catheter extensions, intravascular ultrasound and calcium-modifying tools.

METHODS: We evaluated data from 8,673 CTO PCIs included in the European Registry of Chronic Total Occlusion (ERCTO) between January 2021 and October 2022.

RESULTS: The overall technical success rate was 89.1% and was higher in antegrade as compared with retrograde cases (92.8% vs 79.3%; p<0.001). Compared with antegrade procedures, retrograde procedures had a higher complexity of attempted lesions (Japanese CTO [J-CTO] score: 3.0±1.0 vs 1.9±1.2; p<0.001), a higher procedural and in-hospital MACCE rate (3.1% vs 1.2%; p<0.018) and a higher perforation rate with and without tamponade (1.5% vs 0.4% and 8.3% vs 2.1%, respectively;...

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Volume 20 Number 3
Feb 5, 2024
Volume 20 Number 3
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