Introduction: Chronic total occlusion (CTO) intervention is still challenging because of the limited procedural success rate and higher target lesion failure. It is not clear whether the left anterior descending artery (LAD) lesion will significantly impact on clinical outcomes in patients with CTO treated with drug eluting stents (DES) as compared with those of left circumflex (LCX) and right coronary artery (RCA) lesions.
Methods: A total of 385 consecutive patients who had single CTO lesion underwent successful PCI with DESs were divided according to the different target CTO lesions (LAD CTO: n = 150 pts, LCX CTO: n = 92 pts, RCA CTO: n = 143pts). Five-year clinical outcomes were compared among the three groups.
Results: The baseline clinical characteristics were balanced among the three groups. The major cardiovascular events (MACE) at 5 years showed there was no statistically significant differences among between patients who underwent successful CTO PCI in LAD, LCX, and RCA CTO intervention (LAD = 21.3% vs. LCX = 20.7% vs. RCA = 17.5%, Log rank = 0.555). Each composite of MACE,The incidence of individual major clinical outcomes such as total death, myocardial infarction and revascularization was similar among the three groups up to 5 years (Figure and Table).
Conclusions: The 5- year individual and major clinical outcomes of following successful single CTO intervention were similar among the three groupsmajor epicardial target CTO vessels. Long-term follow up with larger study population will be necessary to get final conclusion.