Late-Breaking Clinical Research Reveals Advances In Chronic Total Occlusion Care And …

By Godson Umejiego, Senior Correspondent, USA

The Minneapolis Heart Institute Foundation® (MHIF) has just presented  late-breaking clinical research showcasing advanced outcomes over the last 10 years with cutting-edge treatment strategies for serious, chronic total occlusions (CTOs), the most complex, total blockages in the coronary arteries. The presentation at the Society for Cardiovascular Angiography and Interventions (SCAI) 2022 Scientific Sessions highlighted an impressive milestone reached with more than 10,000 patients in the PROGRESS-CTO registry (PROspective Global REgiStry for the Study of CTO interventions).

This research initiative was created in 2012 as a collaborative effort for physicians around the world using percutaneous coronary intervention (PCI) techniques to treat CTOs. Dr. Emmanouil Brilakis is the Global Study Chairman and Principal Investigator and MHIF is the coordinating center for the research.

“Many patients have been reluctant to undergo these procedures because of concerns of low success and high complication rates, but this study shows the success is very high at experienced centers,” said MHIF Research Scholar and lead author of the presentation at SCAI 2022, Spyridon Kostantinis, MD. “Since the research registry was created in 2012, we have validated the increasing success in the efficiency of CTO-PCI in recent years without any changes in major adverse cardiac events.”

“The PROGRESS-CTO research contributes to the understanding of the rapid evolution of CTO-PCI techniques and technologies,” said interventional cardiologist and chairman of the MHIF Center for Coronary Artery Disease, Emmanouil Brilakis, MD, PhD,. “We’re still not at 100 percent success with zero complications, which is the ultimate goal and also reinforces there is still room for innovation, in both technique and technology.”

Many CTO patients are faced with limited options because of the complexity of the treatment techniques. The PROGRESS-CTO research examined the clinical and angiographic characteristics and procedural outcomes of 10,249 CTO-PCIs performed in 10,019 patients at 40 centers around the world between 2012 and 2022. Highlights of the data presented:

• Technical and procedural success rates were high (86 per cent and 85 per cent, respectively) and increased over time (p for trend<0.001), despite the high complexity of the lesions
• Overall incidence of in-hospital major adverse cardiac events was 2.1 per cent
• Mean age was 64±10 years and 81 per cent of the patients were men
• Complexity of patients in study indicated by high prevalence of prior PCI (62 per cent), prior coronary artery bypass graft surgery (29 per cent), and diabetes mellitus (43 per cent)
• Over a 10-year period, successful CTO-PCI rates have increased to a high level with improved efficiency

“The PROGRESS-CTO registry contributes to the knowledge base of CTO-PCI operators and provides insights into procedural strategies and outcomes for CTO-PCIs, which will help improve access for all patients over time,” said programme director of the MHIF Center for Coronary Artery Disease and Global Director of the registry since inception, Bavana Rangan, BDS, MPH.