Abstract 15339: Balloon Angioplasty Alone versus Stent Implantation in Chronic Total Occlusion Patients With Small Vessel Disease (<2.5mm)
Background: Chronic total occlusion (CTO) intervention has a lower initial success rate than non-CTO lesions, but has many clinical benefit. Current meta-analysis reported that successful percutaneous coronary intervention (PCI) of CTO lesions resulted in an improvement of left ventricular ejection fraction (LVEF), reduced adverse remodeling and improvement of survival rate. However, there have been very limited published data comparing the clinical outcomes of balloon angioplasty alone and stent implantation in small vessel CTO lesions.
Methods: The Korean CTO registry was collected by retrospectively from 26 major cardiovascular centers since May 2007. A total of 706 consecutive patients (pts) underwent CTO intervention in small vessel CTO lesions (<2.5mm of reference vessel size) were enrolled for this study. Pts were divided into two groups according to the methods of target CTO lesion treatment (plain old balloon angioplasty, POBA alone group, n=156 pts versus Stenting group, n=550 pts). Twelve-month clinical outcomes were compared between the two groups.
Results: The baseline clinical characteristics were similar between the two groups. In-hospital complications were similar between the two groups except intimal dissection which was more frequently occurred in the POBA group. Major clinical outcomes up to 24 months were similar between the two groups; Total major adverse cardiac events (MACE 52% vs. 15%, p=0.952), target lesion revascularization (TLR)-MACE (31% vs. 12%, p=0.343), target vessel revascularization (TVR)-MACE (51% vs. 15% p=0.897) and MACCE (53% vs. 16% p=0.818, Table).
Conclusion: In very small vessel CTO lesions (diameter not exceeding 2.5 mm), revascularization either by POBA alone or stenting showed similar clinical outcomes up to 2 years, suggesting failed DES performance in small vessel CTO lesions.
Author Disclosures: H. Li: None. S. Rha: None. B. Choi: None. J. Byun: None. S. Choi: None. J. Kang: None. W. Kim: None. J. Choi: None. E. Park: None. S. Park: None. S. Lee: None. J. Na: None. C. Choi: None. J. Kim: None. H. Lim: None. E. Kim: None. C. Park: None. H. Seo: None. D. Oh: None.
- © 2016 by American Heart Association, Inc.