Incidence and in-hospital outcomes of single-vessel coronary chronic total occlusion treated with percutaneous coronary intervention

Rajkumar Doshi, Nirav Patel, Rajat Kalra, Harpreet Arora, Navkaranbir S. Bajaj, Garima Arora, Pankaj Arora

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Background: Coronary chronic total occlusion (CTO) using percutaneous coronary intervention (PCI) presents a distinct challenge in the field of cardiology owing to multiple reasons including the increased risk of peri-procedural complications. We sought to explore rates of hospitalization, outcomes, use of mechanical circulatory support devices, and economic burden associated with single-vessel coronary CTO undergoing PCI for stable coronary artery disease (CAD). Methods: The National Inpatient Sample spanning from 2008 through 2014 was queried to identify hospitalizations associated with single-vessel coronary CTO-PCI for stable CAD by excluding hospitalizations with ST-elevation and non-ST elevation myocardial infarction. Survey-Specific logistic regression was used to analyze adjusted incidence of in-hospital mortality and acute renal failure. Results: A total of 109,094 hospitalizations were identified as having single-vessel coronary CTO-PCI for stable CAD from 2008 to 2014. An increasing number of coronary CTO-PCI hospitalizations (2465 to 2688 per 100,000 PCI procedures, P trend < 0.001) with an overall in-hospital mortality of 0.5% was observed. The rate of in-hospital mortality remained unchanged (P trend = 0.13), but an increasing rate of acute renal failure was observed in the multivariate-adjusted analysis (P trend < 0.001). Furthermore, a rise in the utilization of intra-aortic balloon pumps and percutaneous left ventricular assist devices during single-vessel coronary CTO-PCI was noted. Taken together, these may account for increasing costs of hospitalization for single-vessel coronary CTO-PCI ($13,909 in 2008 to $17,729 in 2014, P trend < 0.001). Conclusion: In a large retrospective study, slightly increased rates of single-vessel coronary CTO-PCI for stable CAD were observed. This is accompanied by a rise in morbidity and growing healthcare costs.

Original languageEnglish (US)
Pages (from-to)61-66
Number of pages6
JournalInternational Journal of Cardiology
StatePublished - Oct 15 2018

Bibliographical note

Publisher Copyright:
© 2018 Elsevier B.V.


  • Chronic total occlusion
  • Coronary artery disease
  • Epidemiology
  • Percutaneous coronary intervention


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