Pakistan journal of medical sciences · 2026
Efficacy of previous failure on subsequent procedural outcomes of chronic total occlusion percutaneous coronary intervention: A systematic review and meta-analysis.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Sun Weiqiang, Wu Ailing, Luo Can
Аннотация
OBJECTIVE: The current study aimed to review evidence on the effects of prior failed percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) on subsequent reattempted procedures.
METHODOLOGY: Studies published on the databases of PubMed, Embase, Scopus, and Web of Science comparing outcomes of prior failed CTO-PCI with first-attempt CTO-PCI were included. Random-effects meta-analysis was conducted for baseline characteristics, success rates, and complications.
RESULTS: Six studies were included with 15,803 patients of which 3248 (20.6%) had prior failed PCI for CTO. Patients with prior failed CTO-PCI had significantly lower age, higher Japanese-CTO scores, higher incidence of tortuous vessels, increased contrast volume, and higher fluoroscopy time. The retrograde approach was more frequently used in prior failed cases. Meta-analysis showed that procedural (OR: 0.50 95% CI: 0.32, 0.77 I2=89%) and technical success (OR: 0.69 95% CI: 0.53, 0.88 I2=68%) was significantly lower in cases with prior failed CTO-PCI as compared to those undergoing first attempt CTO-PCI. There was no difference in the risk of major adverse cardiac events (OR: 1.14 95% CI: 0.62, 2.09 I2=47%) and individual complications between the two groups.
CONCLUSIONS: Evidence suggest that cases with prior failed CTO-PCI may have significantly lower procedural and technical success rates as compared to those undergoing first-attempt CTO-PCI. There may be no difference in the risk of complications between the two groups. High heterogeneity precludes strong conclusions. Further studies are needed to improve the quality of evidence. Registration No: PROSPERO under the number CRD420251046077.
METHODOLOGY: Studies published on the databases of PubMed, Embase, Scopus, and Web of Science comparing outcomes of prior failed CTO-PCI with first-attempt CTO-PCI were included. Random-effects meta-analysis was conducted for baseline characteristics, success rates, and complications.
RESULTS: Six studies were included with 15,803 patients of which 3248 (20.6%) had prior failed PCI for CTO. Patients with prior failed CTO-PCI had significantly lower age, higher Japanese-CTO scores, higher incidence of tortuous vessels, increased contrast volume, and higher fluoroscopy time. The retrograde approach was more frequently used in prior failed cases. Meta-analysis showed that procedural (OR: 0.50 95% CI: 0.32, 0.77 I2=89%) and technical success (OR: 0.69 95% CI: 0.53, 0.88 I2=68%) was significantly lower in cases with prior failed CTO-PCI as compared to those undergoing first attempt CTO-PCI. There was no difference in the risk of major adverse cardiac events (OR: 1.14 95% CI: 0.62, 2.09 I2=47%) and individual complications between the two groups.
CONCLUSIONS: Evidence suggest that cases with prior failed CTO-PCI may have significantly lower procedural and technical success rates as compared to those undergoing first-attempt CTO-PCI. There may be no difference in the risk of complications between the two groups. High heterogeneity precludes strong conclusions. Further studies are needed to improve the quality of evidence. Registration No: PROSPERO under the number CRD420251046077.