ArticleJournal of the American Heart Association2026
Procedural Success and Long-Term Outcomes of Percutaneous Coronary Intervention for Chronic Total Occlusion in Small Versus Large Vessels.
Article in Journal of the American Heart Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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11 authors.
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Abstract
backgroundChronic total occlusion (CTO) percutaneous coronary intervention in small vessels (<3.0 mm) poses distinct technical challenges that may affect procedural success and long-term outcomes.
methodsWe analyzed 507 consecutive CTO percutaneous coronary intervention procedures in 456 patients (January 2018-December 2023), categorized as small vessel (n=178, 35.1%) or large vessel (n=329, 64.9%) by reference vessel diameter. The primary end point was a composite of target lesion revascularization, heart failure hospitalization, myocardial infarction, and stroke at median 704-day follow-up.
resultsSmall vessel CTOs were more frequent in women (27.5% versus 17.3%,
conclusionsCTO percutaneous coronary intervention in small vessels is associated with significantly lower procedural success but comparable long-term outcomes. Vessel size is a strong determinant of procedural difficulty; routine incorporation into complexity scoring requires multicenter validation. Current scoring systems may underestimate the complexity of small vessel CTOs, underscoring the need for refined techniques and careful patient selection.
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