Coronary Occlusion Clinical Trial
Official title:
Functional Assessment-guided Angioplasty in Patients With Coronary Chronic Total Occlusion (FAGA-CTO)
The aim of this study is to investigate the role of functional evaluation for predicting clinical outcome in patients with coronary chronic total occlusion (CTO) undergoing percutaneous coronary intervention (PCI), and to evaluate the clinical evidence for the using of fractional flow reserve (FFR), coronary flow reserve (CFR), index of myocardial resistance (IMR) and dynamic single photon emission computed tomography (D-SPECT) in these patients.
PCI for CTO has dramatically changed in recent years. Although, with the improvement of
devices and refinement of operator techniques, PCI of CTO can currently be performed with
high success and low complication rates at experienced centers, the clinical benefit of
recanalization of CTO is still a matter of debate. Accumulating evidence suggests that the
improvement of left ventricular functional and prognosis is closely related with the area of
viable myocardium, which has the potential for contractile recovery after revascularization.
For the majority of interventional cardiologists, coronary angiography is the only invasive
test deemed necessary for clinical decision-making, despite its weak ability to predict the
functional impact of vascular occlusion on the subtended myocardium. To overcome this
limitation, adjunctive diagnostic tools for functional evaluation, such as FFR, CFR, IMR and
D-SPECT, have been introduced. In non-CTO patients, physiology-guided revascularization
strategy has been definitely proven to be better than angiography-guided strategy in pivotal
landmark studies. However, the clinical value of these functional parameters for the PCI of
CTO is still unknown.
The aim of this study was to determine whether functional evaluation is a better predictor of
clinical outcome in patients with CTO undergoing PCI.
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