Coronary artery spatial distribution of chronic total occlusions: Insights from a large US registry

Objective To assess the spatial distribution of chronic total occlusions (CTOs) within the coronary arteries and describe procedural strategies and outcomes during CTO percutaneous coronary intervention (PCI). Background Acute occlusions due to plaque rupture tend to cluster within the proximal third of the coronary artery. Methods We examined the clinical and procedural characteristics of 1,348 patients according to lesion location within the coronary tree. Results A total of 1,369 lesions in 1,348 patients (mean age 66 ± 10 years, 85% male) were included. CTO PCI of proximal segments (n = 633, 46%) was more common than of mid (n = 557, 41%) and distal segments (n = 179, 13%). Patients undergoing CTO PCI of proximal segments were more likely to be smokers (P