Defying Demographic Barriers: High Procedural Success of CTO-PCI in a Real-World
DOI:
https://doi.org/10.31004/ijisk.v3i4.811Keywords:
Chronic Total Occlusion, Percutaneous Coronary Intervention, Procedural Success, Gender Paradox, High-Volume CenterAbstract
Chronic Total Occlusion (CTO) historically represented the "final frontier" in percutaneous coronary intervention, frequently resulting in surgical referral due to high failure rates. Procedural success was traditionally hypothesized to be limited by patient-specific demographic factors, such as advanced age and female gender, alongside the urgency of clinical presentation. To address this clinical gap, this study aimed to evaluate the real-world success rates of CTO interventions and determine whether these baseline demographic and clinical factors significantly predict procedural outcomes. A retrospective observational study was conducted using big data analytics on a catheterization logbook from a high-volume center, yielding a cohort of 187 patients who underwent CTO-PCI. Procedural outcomes, age, gender, and clinical status (emergency vs. elective) were evaluated using bivariate analysis and multivariable logistic regression. The findings reveal an exceptionally high overall procedural success rate of 93.0%. Statistical modeling demonstrates that advanced age, female gender, and emergency clinical status do not significantly predict procedural failure. Operator expertise and advanced crossing techniques effectively neutralize the anatomical complexities traditionally associated with adverse demographic profiles. In conclusion, CTO-PCI is highly safe and efficacious across diverse patient demographics; thus, patients must not be denied minimally invasive revascularization based on perceived, yet statistically unproven, demographic limitations.
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