CTO PCI — Key Points (JACC 2026)
CTO PCI — Key Points (JACC 2026)
• CTO PCI improves symptoms & quality of life vs optimal medical therapy (OMT) and –
• Benefit strongest in:
• Single CTO lesion
• Symptomatic patients
Clinical Impact
• ❌ No clear reduction in:
• Death
• MI
Benefit = symptom relief (not survival)
Effect seen by 12 months
Key Evidence
• Meta-analysis of:
• EUROCTO + DECISION-CTO
Success & Safety
• Procedural success:
• ~89% → >92%
Guidelines Context
• 🇺🇸 US: Class IIb
• 🇪🇺 Europe: Class IIa
Limitation:
• Complexity + operator dependency
Practical Takeaway
CTO PCI = symptom-driven decision
Consider in:
• Refractory angina
• Single CTO
• Experienced operator
Source: JACC 2026 / TCTMD coverage
Source: JACC 2026 | TCTMD (April 9, 2026)
