Safety of coronary angioplasty to chronic total occlusions

Percutaneous transluminal coronary angioplasty (PTCA) of chronic total occlusions (CTO) is not performed routinely in some centres due to concerns of low procedural success rates and high rates of short-term complications. This retrospective study examines the safety of PTCA to CTO in 100 consecutive cases compared to 100 matched controls. Success rate was 79% for CTO versus 98% for controls (p<0.001), however 5% of CTO patients had a cardiac enzyme rise compared to 13% of controls (p<0.05) and 0% of CTO patients compared to 6% of controls had a significant enzyme rise (p=0.03). These results suggest that PTCA to CTO can be carried out successfully in the majority of patients with only a relatively small risk of myocardial necrosis.