Stenting improves long term outcomes in CTO PCI patients

In patients undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI), stenting demonstrated improved long-term survival and fewer cardiac arrests at one year. The late-breaking data were presented today at the Society for Cardiovascular Angiography & Interventions (SCAI) 2025 Scientific Sessions.

Coronary artery disease (CAD) is the most common type of heart disease and a leading cause of death worldwide. CTO PCI is a minimally invasive procedure to treat CAD by reopening blocked arteries with a catheter and stent. CTO PCI is a challenging procedure and has been associated with lower success and higher in-hospital event rates compared to non-CTO PCI. The decision to place a stent may significantly impact clinical outcomes. While stenting improves blood vessel blockage or obstruction, the long-term benefits of stenting in CTO PCI remain debated. 

The retrospective, single-center observational study evaluated the association between stented versus non-stented CTOs at a high-volume PCI center. Patients were stratified into stented and non-stented groups. Baseline characteristics were assessed using descriptive statistics. 

A total of 677 patients underwent CTO PCI, with 81.2% receiving stents. Stenting was associated with improved long-term outcomes, including a lower risk of cardiovascular death at six months (adjusted odds ratio 0.20, 95% confidence interval 0.06–0.71) and a lower incidence of cardiac arrest at one year (adjusted odds ratio 0.21, 95% confidence interval 0.06–0.72). No significant differences were observed in 30-day all-cause mortality or in-hospital complications. 

While stenting is widely accepted as beneficial for patients with total blockages, the data presented at SCAI Scientific Sessions provides further evidence that it should be considered safe and effective in the long term. Our study provides evidence that stenting can be an important treatment option for patients undergoing CTO PCI."

M Chadi Alraies, MD, MPH, FACC, FSCAI, Clinical Associate Professor of Medicine at Wayne State University School of Medicine, Medical Director Cardiac Catheterization Lab at Detroit Medical Center in Detroit, Mich. and lead author of the study

The authors note that further studies are needed to refine treatment strategies and optimize CTO PCI outcomes.