The interest of coronary chronic total occlusion (CTO) revascularization by percutaneous angioplasty (PCI) remains debated.

To study the effectiveness of CTO-PCI on angina pectoris symptoms as the primary endpoint, on LVEF evolution and mid-term prognosis outcomes as the secondary endpoints.

All patients who benefited from a CTO-PCI attempt in our center over a period of 48months were included. The major adverse cardiovascular event (MACE) composite criteria included all-cause mortality, non-fatal myocardial infarction, non-fatal stroke, and any new coronary revascularization (Table 1).

One hundred and thirty-nine patients were included with a median follow-up of 450days. A procedural success was obtained for 88% of the patients. A decrease in the proportion of patients with angina pectoris symptoms (P<0.001) and an improvement in LVEF when it was impaired (P<0.001) were demonstrated in the “Procedural success” group, unlike the “Procedural failure” group (respectively P=1 and P=0.07). Finally, there was a tendency to an improvement in the risk of MACE in the “Procedural success” group (HR=0.60, 95% CI 0.23 to 1.56, P=0.3) (Fig. 1).

A success of percutaneous CTO revascularization allowed in our study to decrease drastically the symptomatology of angina pectoris, and to improve the LVEF by on average 10 points, without a significant relationship between successful CTO-PCI and patient prognosis improvement.