Registry for the Safety and Success of Percutaneous Coronary Intervention of Chronic Total Occlusion in Ain Shams University Hospitals

Background: Chronic total occlusion (CTO) of coronary arteries remains a challenging scenario in percutaneous coronary intervention (PCI), with success and safety highly dependent on the approach and lesion characteristics. Objective: This registry was established to assess procedural strategies, success rates, and complications among patients undergoing CTO PCI at Ain Shams University Hospitals over an eight-month period. Patients and methods: This registry included 62 patients who underwent CTO PCI through the period from July 1, 2020, to February 28, 2021. Comprehensive patient and procedural data including lesion and technical details, were collected and analyzed using SPSS version 26. Complications, major adverse cardiac events (MACE), and procedural success rates were assessed and compared between antegrade and retrograde approaches. Results: Procedural success was achieved in 91.9% of cases, with 93.5% technical success. The retrograde approach was associated with longer procedure (120 vs. 63 minutes, P = 0.005) and fluoroscopy times (82 vs. 47 minutes, P = 0.002), as well as higher radiation (6909 vs. 3890 my, P = 0.018) and contrast doses (475 vs. 300 mL, P = 0.006). Complications occurred in 32.3% of cases, predominantly dissection (25.8%). In-hospital MACE was low, with only one death (1.6%) and one stroke (1.6%). Conclusion: CTO PCI demonstrated high success rates in an experienced center, though procedural complexity, which remained significant, particularly with the retrograde approach. This registry highlighted lesion-specific risks and procedural factors that influence success and complication rates, guiding optimal strategy selection for CTO PCI.