<div ng-repeat="item in XocsCtrl.sections" ng-class="{'early-item': $index < 2}" class="s-content ng-scope early-item"> <div data-once-html="item"> <p id="hl0000019" class="ng-scope">Japanese operators have been at the forefront in continuously improving techniques and CTO wire design for high procedural success rate and patient outcomes.</p> <p id="hl0000020" class="ng-scope">In this edition of CRM (CRM reference), registry data is reported on outcomes of CTO PCI in patients with multivessel disease (MVD) in whom a chronic total occlusion (CTO) is present compared with those who have single vessel disease (SVD) with a CTO. While the time course of intervention in other vessels is not discussed, it is heartening to know that procedural success rates continue to improve with 87.2% in patients with MVD and CTO PCI vs 90.2% in single vessel CTO PCI with comparable clinical outcomes compared to previous reports.</p> <p id="hl0000021" class="ng-scope">Two thirds of patients with MVD had a CTO. Retrograde approach was used in 1/3rd of cases in both CTO with MVD and single vessel CTO. Fluoroscopic time, contrast use and total procedure time was similar in both groups. While J CTO scores were similar, CTO's in those with MVD were more calcified with second attempts being more common. The authors were cognizant in not attempting CTO PCI in a non -infarct vessel in the setting of acute myocardial infarction but treated stenoses that were moderate to severe in the donor vessels that supplied collaterals before CTO PCI was attempted.</p> <p id="hl0000022" class="ng-scope">PCI performed with changing patient profile to include those with multiple co morbidities, MVD with a CTO and increasing lesion complexity refected in the J-CTO score. In contrast to previous reports procedural pre planning with standardized methodical approach to CTO lesions through education and training resulted in comparable major adverse cardiovascular and cerebrovascular (MACCE) events.</p> <p id="hl0000023" class="ng-scope">In summary, while these are registry results, patient level improvements continue to evolve in the right direction for CTO PCI in those with MVD vs single vessel CTO PCI.</p> <section class="journal-head-matter ng-scope"> <dl class="author-group" id="hl0000010"></dl> </section> </div> </div>