Cor Vasa 2026, 68(3):273-278

Clinical and Angiographic Outcomes after Contemporary Extraplaque Compared to Intraplaque Recanalization of Chronic Total Occlusion: a 6-Month Follow-up Observational Study

Peter Philip Shaker Selwanosa, b, Ahmad Samirb, Sameh Bakhoumb, Magdy Abdelhamidb, Ahmed ElGuindya
a Division of Cardiology, Aswan Heart Center, Aswan, Egypt
b Department of Cardiovascular Medicine, Faculty of Medicine, Kasr Al Ainy, Cairo University, Egypt

Aim: The expanding utilization of extraplaque (EP) strategies has led to increasing success rates in coronary chronic total occlusion (CTO) recanalization. The contemporary EP techniques have replaced the precedent dissection and reentry techniques and have shown mid-term outcomes comparable to intraplaque (IP) approaches. Clinical and angiographic outcomes need to be evaluated. The aim of this study was to assess clinical and angiographic outcomes across different CTO-PCI techniques.

Methods: This was a prospective, observational, analytic, single-center study recruiting 50 consecutive patients who underwent successful CTO PCI. The CTO PCI technique (EP vs. IP) was according to the operator's discretion. The primary endpoint was contrasting the impact of the PCI technique on the clinical and angiographic outcomes, 6 months after the index PCI.

Results: Fifty consecutive patients had successful PCI to 51 CTO coronary vessels. EP and IP techniques were used in 15 and 36 CTOs, respectively. At 6 months, clinical and angiographic follow-ups were completed for all patients. Target vessel failure (TVF) occurred in 23.5% of all patients with a numerically higher rate in the EP compared to the IP technique but without achieving statistical significance (26.6% vs. 22.2%; p = 0.73).

Conclusions: CTO recanalization using EP techniques is associated with non-significant difference in TVF compared to IP techniques.

Keywords: Chronic total occlusion, Extraplaque, Intraplaque

Received: July 27, 2025; Revised: July 27, 2025; Accepted: September 6, 2025; Prepublished online: June 2, 2012; Published: July 1, 2026  Show citation

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Shaker Selwanos PP, Samir A, Bakhoum S, Abdelhamid M, ElGuindy A. Clinical and Angiographic Outcomes after Contemporary Extraplaque Compared to Intraplaque Recanalization of Chronic Total Occlusion: a 6-Month Follow-up Observational Study. Cor Vasa. 2026;68(3):273-278.
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