Chronic Total Occlusion (CTO)
Conditions
Keywords
CTO, Coronary Chronic Total Occlusion, Coronary artery disease, Coronary intervention, Collateral channel
Brief summary
Coronary chronic total occlusions (CTO) present a significant challenge in the field of interventional cardiology. These complex lesions, characterized by complete blockage of a coronary artery for a prolonged duration, often require specialized techniques and strategies to achieve successful revascularization.
Detailed description
Using this consortium, we will establish a multicenter cohort to evaluate the clinical parameters, angiographic characteristics, interventional techniques, and clinical outcomes involved in coronary CTO intervention. 3 subprojects are listed here. Subproject 1 intends to develop a novel algorithm integrating antegrade and retrograde scoring system to optimize the CTO intervention and determine the optimal timing for primary retrograde approach. Current algorithm for CTO intervention. Subproject 2 aims to examine the strategies and outcomes of CTO involving bifurcations. Bifurcation CTO lesions present unique challenges due to their complex anatomy. Opening of the main vessel while preserving important branches is crucial for ensuring favorable long-term clinical prognosis. This subproject will investigate different strategies and devices employed in bifurcation CTO PCI to assess their efficacy and safety outcomes. Subproject 3 investigates the treatment strategies for right coronary artery (RCA) CTOs with concomitant left main disease, which present a unique and intricate scenario, requiring careful consideration of revascularization strategies.
Interventions
Coronary CTO was identified by coronary angiography, and its revascularization was attempted by either antegrade, retrograde or both approach.
Sponsors
Study design
Eligibility
Inclusion criteria
1. Over 20 years old 2. Chronic total occlusion confirmed by coronary angiography, and noted for more than 3 months
Exclusion criteria
Nil
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of participants with technical success of CTO revascularization | 1 day | Successful CTO recanalization with \<20% residual stenosis within the treated segment and restoration of Thrombolysis in Myocardial Infarction grade 3 antegrade flow, without side branch loss |
| Number of participants with collateral channel tracking success | 1 day | retrograde guidewire crossing the CC to reach the distal cap of CTO segment. |
| Number of participants with major adverse cerebral cardiovascular events | 5 years | Death, CV death, myocardial infarction, stroke, repeat revascularization |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of participants with periprocedural myocardial infarction | 1 day | Confirmed by |
| Number of participants with periprocedural complications | 1 day | Periprocedural myocardial infarction, vessel perforation, stroke, urgent or emergent revascularization |
Countries
Taiwan