CABG Versus PCI in Patients With Isolated LAD Chronic Total Occlusion

NCT07373678 | Completed

• 1 other identifier: MLP-SSURAL-002
• Study Type: observational
• Target: 302
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to compare coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in the treatment of isolated chronic total occlusion (CTO) of the left anterior descending (LAD) artery in terms of short- and mid-term clinical outcomes, myocardial revascularization success, and complication rates.

Conditions

Chronic Total Occlusion

Keywords

Chronic total occlusion; Coronary artery bypass; Percutaneous coronary intervention; left anterior descending artery; isolated LAD CTO

Outcome Measures

Primary Outcomes (1)

• Procedural success

  Successful completion of coronary revascularization of the left anterior descending artery without in-hospital major adverse cardiac events.

  perioperatively / periprocedurally

Secondary Outcomes (1)

• Major adverse cardiac events (MACCE) at 3 years

  3 years

Study Arms (2)

Coronary Artery Bypass Grafting (CABG)

Patients with isolated chronic total occlusion of the left anterior descending artery who underwent coronary artery bypass graft surgery.

Procedure: Coronary Artery Bypass Grafting

Percutaneous Coronary Intervention (PCI)

Patients with isolated chronic total occlusion of the left anterior descending artery who underwent percutaneous coronary intervention.

Procedure: Percutaneous Coronary Intervention

Interventions

Coronary Artery Bypass Grafting PROCEDURE

Coronary artery bypass graft surgery performed as part of routine clinical care prior to study inclusion.

Coronary Artery Bypass Grafting (CABG)

Percutaneous Coronary Intervention PROCEDURE

Percutaneous coronary intervention performed as part of routine clinical care prior to study inclusion.

Percutaneous Coronary Intervention (PCI)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study population consists of adult patients aged 18 years or older with isolated chronic total occlusion (CTO) of the left anterior descending (LAD) coronary artery who underwent coronary revascularization with either coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) as part of routine clinical care. Isolated LAD CTO was defined as a de novo or in-stent total occlusion confined to the LAD artery, without significant coronary artery disease (≥50% stenosis) in other major epicardial coronary arteries. Patients with prior coronary revascularization, multiple CTOs, severe left ventricular dysfunction, or incomplete follow-up data were excluded.

You may qualify if:

• Age 18 years or older at the time of the index procedure.
• Diagnosis of isolated chronic total occlusion (CTO) of the left anterior descending (LAD) coronary artery.
• Isolated LAD CTO defined as a de novo or in-stent total occlusion confined to the LAD artery, without significant coronary artery disease (defined as ≥50% stenosis) in other major epicardial coronary arteries, including the left circumflex (LCx), right coronary artery (RCA), or major side branches.
• No prior percutaneous coronary intervention (PCI) performed in non-LAD coronary arteries.
• Patients who underwent coronary revascularization with either coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) for isolated LAD CTO.

You may not qualify if:

• History of malignancy or active malignant disease at the time of the index procedure.
• Prior coronary artery bypass grafting (CABG) or prior percutaneous coronary intervention (PCI) performed in non-LAD coronary arteries.
• Presentation with ST-segment elevation myocardial infarction (STEMI).
• Discontinuation of prescribed medical therapy by patient preference within one year after the index procedure.
• Presence of multiple chronic total occlusions (CTOs) involving more than one coronary artery.
• Significant side branch disease of the LAD requiring two bypass grafts.
• Performance of crossover stenting from the LAD into the left main coronary artery during LAD CTO-PCI.
• Treatment of LAD CTO with drug-eluting balloon (DEB) angioplasty without stent implantation.
• Left ventricular ejection fraction (LVEF) less than 30%.
• Presence of severe valvular heart disease (e.g., severe aortic or mitral stenosis or regurgitation).
• Incomplete angiographic or clinical follow-up data.
• Use of mechanical circulatory support devices due to advanced heart failure, including intra-aortic balloon pump (IABP), extracorporeal membrane oxygenation (ECMO), or left ventricular assist device (LVAD).

Sponsors & Collaborators

• Mersin Medicalpark Hastanesi: lead
• Biruni University: collaborator
• Mersin Training and Research Hospital: collaborator
• Necmettin Erbakan University: collaborator
• Jolimont Hospital: collaborator
• Minneapolis Heart Institute: collaborator

Study Sites (1)

Sefa SURAL

Mersin, 33010, Turkey (Türkiye)

Location

MeSH Terms

Interventions

Coronary Artery Bypass; Percutaneous Coronary Intervention

Intervention Hierarchy (Ancestors)

Myocardial Revascularization; Cardiac Surgical Procedures; Cardiovascular Surgical Procedures; Surgical Procedures, Operative; Vascular Grafting; Vascular Surgical Procedures; Thoracic Surgical Procedures; Endovascular Procedures; Minimally Invasive Surgical Procedures

Study Officials

• Sefa SURAL, MD

  Toros University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor of Cardiology

Study Record Dates

• First Submitted: January 17, 2026
• First Posted: January 28, 2026
• Study Start: September 10, 2025
• Primary Completion: December 31, 2025
• Study Completion: January 15, 2026
• Last Updated: January 28, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)