# The outcomes and complications of percutaneous interventions in chronic total coronary occlusion

## TL;DR

This study examines the success and complications of chronic total occlusion PCI procedures in Pakistan, finding a high success rate and identifying diabetes as a risk factor for failure.

## Contribution

The study provides insights into CTO PCI outcomes in a Pakistani medical center with limited resources.

## Key findings

- CTO was successfully re-vascularized in 77.5% of patients.
- The complication rate was 13.7%, with diabetes linked to higher procedural failure.
- RCA was the most common target vessel, and the antegrade approach was used in 97.39% of cases.

## Abstract

The limited availability of complex coronary intervention facilities and qualified operators, due to the high cost associated with chronic total occlusion (CTO) percutaneous intervention (PCI) equipment and a shortage of necessary skills, has led to a scarcity of capable medical centers in Pakistan. This study seeks to examine the outcomes and potential complications associated with CTO PCI procedures conducted at the Cardiac Catheterization Laboratories of a prominent national institute in Pakistan, which handles a large volume of cases.

Three hundred and six patients were included in the study in the study period of six months. The mean age was 59.49 (± 9.16) years: 256 (83.66%) were male and 50 (16.34%) were female. CTO was successfully re-vascularized in 237 (77.5%) with a complication rate of 13.7%. Two hundred and ninety-eight (97.39%) patients underwent an antegrade approach, while RCA was the most common target vessel (47.71%). Diabetes was the only significant associated risk factor with CTO PCI failure (30.43% vs. 30.43%, P-value = 0.015).

We achieved an excellent procedural success rate with a low complication rate. CTO procedural failure is associated with a higher complication rate, and diabetes is among the risk factors that lead to higher procedural failure.