Letter to the editor

DOI: 10.4244/EIJ-D-23-00830

Letter: Due to the lack of significant mortality benefit along with high procedural complication rates, percutaneous coronary intervention of chronic total occlusions should be discouraged

Mohammad Reza Movahed1, MD, PhD

With great interest, I read the manuscript entitled “Three-year Outcomes of A Randomised Multicenter Trial Comparing Revascularization and Optimal Medical Therapy for Chronic Total Coronary Occlusions (EuroCTO)” in EuroIntervention1. They confirmed numerous previous data that chronic total occlusion (CTO) interventions do not improve clinically significant outcomes, myocardial infarction or mortality. However, the authors overstated the benefit of a CTO intervention by stating that CTO percutaneous coronary intervention (PCI) appears to be a safe option for patients with a single remaining significant coronary CTO. The authors completely downplayed numerous trials showing very high complication rates in patients undergoing CTO PCI in comparison to other lesions23. We recently published the largest data regarding CTO PCI confirming much higher in-patient mortality and complications in this population4. A weighted total of 259,574 patients underwent CTO PCI. The CTO patients had a 3.17% mortality rate versus 2.57% for non-CTO PCIs (odds ratio [OR] 1.24), which remained significant despite adjusting for numerous baseline and clinical characteristics. Furthermore, patients with CTO were compared with non-CTO PCI, showing much higher rates of myocardial infarction...

Sign in to read
the full article

Forgot your password?
No account yet?
Sign up for free!

Create my pcr account

Join us for free and access thousands of articles from EuroIntervention, as well as presentations, videos, cases from PCRonline.com

Volume 20 Number 1
Jan 1, 2024
Volume 20 Number 1
View full issue


Key metrics

Suggested by Cory

Editorial

10.4244/EIJ-E-23-00040 Sep 18, 2023
Reconsidering the evidence for CTO PCI: the devil is in the detail
Al-Lamee R et al
free

10.4244/EIJV12I11A218 Dec 9, 2016
Conquering CTO revascularisation: the summit is near with 90% of the ascent behind us
Di Mario C and Dini C
free

Research correspondence

10.4244/EIJ-D-22-00599 Dec 2, 2022
In-hospital outcomes and temporal trends of percutaneous coronary interventions for chronic total occlusion
Kostantinis S et al
free
Trending articles
152.9

Clinical research

10.4244/EIJ-D-20-01125 Oct 20, 2021
An upfront combined strategy for endovascular haemostasis in transfemoral transcatheter aortic valve implantation
Costa G et al
free
47.8

NEW INNOVATION

10.4244/EIJ-D-15-00467 Feb 20, 2018
Design and principle of operation of the HeartMate PHP (percutaneous heart pump)
Van Mieghem NM et al
free
39.1

Clinical research

10.4244/EIJ-D-22-00558 Feb 6, 2023
Permanent pacemaker implantation and left bundle branch block with self-expanding valves – a SCOPE 2 subanalysis
Pellegrini C et al
free
X

The Official Journal of EuroPCR and the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

EuroPCR EAPCI
PCR ESC
Impact factor: 7.6
2023 Journal Citation Reports®
Science Edition (Clarivate Analytics, 2024)
Online ISSN 1969-6213 - Print ISSN 1774-024X
© 2005-2024 Europa Group - All rights reserved