Drug-Coated Balloons in Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From the PROGRESS-CTO Registry
Recommended Citation
Mutlu D, Rempakos A, Strepkos D, Carvalho PEP, Alexandrou M, Kladou E, Ser OS, Azzalini L, Jaffer FA, Ybarra L, Goktekin O, Uluganyan M, Ozdemir R, Elbarouni B, Alaswad K, Davies R, ElGuindy A, Kocas C, Sural S, Poommipanit P, Frizzel J, Basir MB, Raj L, Young L, Rangan BV, Mastrodemos OC, Sara JDS, Jalli S, Sandoval Y, Burke MN, Brilakis ES, and Gorgulu S. Drug-Coated Balloons in Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From the PROGRESS-CTO Registry. Catheter Cardiovasc Interv 2025;106(7):3783-3795.
Document Type
Article
Publication Date
12-1-2025
Publication Title
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
Keywords
Humans, Registries, Coronary Occlusion, Male, Female, Treatment Outcome, Aged, Chronic Disease, Time Factors, Middle Aged, Risk Factors, Coated Materials, Biocompatible, Cardiac Catheters, Angioplasty, Balloon, Coronary, Retrospective Studies, Risk Assessment, Drug-Eluting Stents
Abstract
BACKGROUND: There is limited information on the use of drug-coated balloons (DCBs) in chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
AIMS: To assess the frequency and outcomes of DCB use in CTO PCI.
OBJECTIVE: This study evaluated the frequency and outcomes of DCB use in a large, multicenter CTO PCI registry.
METHODS: We analyzed 12,146 patients who underwent 12,157 successful CTO PCIs at 59 centers from 2018 to 2025.
RESULTS: DCBs were used in 454 patients (3.7%) with increasing frequency over time (p = 0.020). A DCB-only strategy was used in 48.4% of the patients and a hybrid strategy combining DCBs and drug-eluting stents (DES) was used in 51.6% of patients. Patients treated with DCB (both strategies) had low prevalence of comorbidities. Compared with the DES cases, DCB only cases had favorable angiographic characteristics, lower mean J-CTO (Japanese CTO) score (1.83 ± 1.03 vs. 2.27 ± 1.23; p < 0.001), and similar technical success (96.3% vs. 97.3%; p = 0.640), and in-hospital major adverse cardiac events (MACE). The hybrid and DCB-only strategies had comparable technical success and in-hospital MACE. During a median follow-up of 323 (170-429) days, DCB only cases had lower MACE than the other strategies (hazard ratio [HR] 0.41, 95% CI 0.17-0.96, p = 0.040). After multivariable adjustment, the association remained significant (HR 0.39, 95% CI 0.16-0.92, p = 0.032).
CONCLUSIONS: DCBs are increasingly being used in CTO PCI. A DCB only strategy was used in less complex lesions and was associated with similar technical success and in-hospital MACE compared with hybrid or DES strategies. A DCB only strategy was associated with lower long-term MACE.
Medical Subject Headings
Humans; Registries; Coronary Occlusion; Male; Female; Treatment Outcome; Aged; Chronic Disease; Time Factors; Middle Aged; Risk Factors; Coated Materials, Biocompatible; Cardiac Catheters; Angioplasty, Balloon, Coronary; Retrospective Studies; Risk Assessment; Drug-Eluting Stents
PubMed ID
41084138
ePublication
ePub ahead of print
Volume
106
Issue
7
First Page
3783
Last Page
3795
