Iranian Heart Journal

Iranian Heart Journal

Impact of Clinical and Angiographic Criteria on Procedural Outcomes and Target Lesion Revascularization After Percutaneous Coronary Intervention for Chronic Total Occlusion

Document Type : Original Article

Authors
Yasser Ahmed Abd EL Hady 1
Mohamed Ismail Mahmoud 2
Khaled Refaat Abd EL Meguid 1
Osama Ahmed Amin 1
1 Department of Cardiology, Faculty of Medicine, Beni-Suef University, Egypt.
2 Department of Cardiology, Beni-Suef Health Insurance Hospital, Egypt.
Abstract
Background: Coronary chronic total occlusion (CTO) recanalization aims to improve myocardial perfusion in the corresponding ischemic territory. Successful CTO percutaneous coronary intervention (PCI) improves quality of life and left ventricular function.
Objectives: To investigate preprocedural predictors of successful antegrade CTO recanalization in two centers with limited resources and to evaluate procedural and midterm clinical outcomes after successful CTO recanalization.
 
Methods: This prospective study included 70 patients recruited from 2 centers with limited CTO PCI resources. The primary outcomes were procedural success rate, target lesion revascularization (TLR) at 1 year, and midterm success rate according to J-CTO scores. The secondary outcomes were major adverse cardiac events.
 
Results: J-CTO score variables were significant in predicting procedural success. A cutoff score of ≥2 was associated with procedural failure, with 100% sensitivity and 91% specificity, and may be used as a negative predictive factor when treating CTO lesions. A significant association was observed between the need for TLR, the presence of diabetes, and vessel angulation.
 
Conclusions: In resource-limited centers, use of an antegrade approach in patients with CTO lesions and lower J-CTO scores is expected to achieve higher midterm success rates compared with patients with higher J-CTO scores. (Iranian Heart Journal 2025; 26(4): 69-84)
Keywords
Coronary total occlusion
Major adverse cardiac events
Procedural success
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Iranian Heart Journal
Volume 26, Issue 4
Autumn 2025
Pages 69-84