Assessment of reattempted percutaneous coronary intervention strategy for chronic total occlusion after prior failed procedures: Analysis of the Japanese CTO‐PCI Expert Registry

Objectives We aimed to investigate strategies for reattempted percutaneous coronary interventions (PCIs) for chronic total occlusions (CTOs) by highly skilled operators after a failed attempt. Background Development of complex techniques and algorithms has been standardized for CTO‐PCI. However, there is no appropriate strategy for CTO‐PCI after a failed procedure. Method From 2014 to 2016, the Japanese CTO‐PCI Expert Registry included 4,053 consecutive CTO‐PCIs (mean age: 66.8 ± 10.9 years; male: 85.6%; Japanese CTO [J‐CTO] score: 1.92 ± 1.15). Initial outcomes and strategies for reattempted CTO‐PCIs were evaluated and compared with first‐attempt CTO‐PCIs. Results Reattempt CTO‐PCIs were performed in 820 (20.2%) lesions. The mean J‐CTO score of reattempt CTO‐PCIs was higher than that of first‐attempt CTO‐PCIs (2.86 ± 1.03 vs. 1.68 ± 1.05, p