- Question
- Does percutaneous coronary intervention of a chronic total occlusion (CTO PCI) relieve angina more than a placebo procedure in patients with stable angina?
- Design
- Multicenter, randomized, blinded, placebo-procedure-controlled trial enrolling 50 patients between October 2021 and October 2025. Blinding was maintained with auditory isolation and deep conscious sedation; symptoms were recorded daily with the ORBITA app and assessments were repeated at 6 months.
- Population
- Patients with angina attributable to a single-vessel chronic total occlusion, without bystander coronary disease.
- Intervention
- CTO PCI (25 patients). Antianginal medications were stopped at randomization and reintroduced on a patient-initiated protocol.
- Control
- Placebo procedure (25 patients), with the same antianginal medication handling.
- Primary outcome
- Angina symptom score, an ordinal scale combining daily symptom burden from the ORBITA app, antianginal use and over-ride events.
- Results
- CTO PCI improved the symptom score versus placebo in an immediate and sustained manner (OR 4.38; 95% credible interval 1.57-12.69; probability of benefit 0.996), with a clear reduction in angina episodes (OR 4.38; 95% CrI 1.55-11.78). There were 30.6 additional angina-free days (95% CrI 11.1-50.7).
- Safety
- One patient randomized to PCI was withdrawn during the procedure because of a complication; all patients were included in the primary analysis.
- Conclusion
- In patients with symptomatic single-vessel CTO, CTO PCI improves angina beyond placebo.
- Why it matters
- It provides the first randomized, blinded, placebo-controlled evidence that CTO PCI relieves symptoms, supporting its use for symptom relief in selected patients.
Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.
Generated on October 14, 2026