Predictors of Procedural Success and Complications in Percutaneous Coronary Intervention for Chronic Total Occlusions

Abstract

Abstract

Objective: To identify the predictors of procedural success and complications in Percutaneous Coronary Intervention (PCI) for Chronic Total Occlusions (CTOs) in patients at Hayatabad Medical Complex, Peshawar, Pakistan.

Methodology: A retrospective cohort study was conducted with 150 patients who underwent PCI for CTO between June 2024 and June 2025. Demographic data, lesion characteristics, procedural details, and complications were analyzed. Statistical analysis included descriptive statistics, chi-square tests, independent t-tests, and multivariable logistic regression to identify predictors of procedural success.

Results: The study found that 78% of patients had procedural success, while 22% had failed procedures. Significant predictors of success included age (p = 0.04), J-CTO score (p = 0.002), and approach used (p = 0.01). Males had a significantly higher procedural success rate compared to females (p = 0.03). Logistic regression revealed that younger age (OR = 0.98, p = 0.03), lower J-CTO score (OR = 1.5, p = 0.01), and antegrade approach (OR = 2.0, p = 0.05) were independent predictors of success.

Conclusion: The study concludes that procedural success in CTO PCI is influenced by patient age, lesion complexity, and the approach used. These findings are important for guiding clinical decisions in CTO PCI, suggesting that younger patients with less complex lesions and an antegrade approach should be prioritized. Future studies with larger, multicenter cohorts are needed to validate these results.

Keywords: Chronic total occlusion, Percutaneous coronary intervention, J-CTO score, Procedural success, Logistic regression.