Coronary disease & ACSCohort study
Outcomes of Percutaneous Coronary Intervention for Chronic Total Occlusion With Bifurcation at Distal Cap
- Registry-based cohort study
- multicentre registry
Authors' conclusion
Although there are concerns about the success rate when a bifurcation is present distal to the CTO, it has been shown that the combined use of the retrograde approach can achieve a high success rate equivalent to that of lesions without bifurcations.
Study context
- Population
- Patients undergoing chronic total occlusion (CTO) PCI in the Japanese CTO-PCI Expert Registry with an analyzable distal cap, January 2014–December 2022
- Participants
- 11,627 patients
- Exposure
- CTO with vs without bifurcation at distal cap
- Bifurcationn = 2,462
- No bifurcationn = 9,165reference
- Outcome
- Procedural outcomes and adverse events
Main finding
As reported in the abstract
Procedural outcomes
- No significant differences in guidewire, technical or procedural success between the two groups
- Bifurcation: longer procedure time, more contrast volume, longer fluoroscopy time
Observational data: associations, not effects.
Further findings
Retrograde approach use
P < 0.001
Retrograde approach use, right coronary artery (subgroup)
P < 0.001
Retrograde approach use, left circumflex artery (subgroup)
P = 0.044
Bifurcation at distal cap (prevalence)
- Bifurcation present in CTO lesions
- 21.2% (n = 2,462 of 11,627)
Original publication
Outcomes of Percutaneous Coronary Intervention for Chronic Total Occlusion With Bifurcation at Distal Cap. JACC Cardiovasc Interv. Published 12 May 2025. doi:10.1016/j.jcin.2025.03.024
Summarised from the published abstract; every number is checked against it