{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T00:44:44Z","timestamp":1775177084953,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,3,8]],"date-time":"2023-03-08T00:00:00Z","timestamp":1678233600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Gender\u2010specific data addressing percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) in female patients are scarce and based on small sample size studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>We aimed to analyze gender\u2010differences regarding in\u2010hospital clinical outcomes after CTO\u2010PCI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from 35,449 patients enrolled in the prospective European Registry of CTOs were analyzed. The primary outcome was the comparison of procedural success rate in the two cohorts (women vs. men), defined as a final residual stenosis less than 20%, with Thrombolysis In Myocardial Infarction grade flow\u2009=\u20093. In\u2010hospital major adverse cardiac and cerebrovascular events (MACCEs) and procedural complications were deemed secondary outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Women represented 15.2% of the entire study population. They were older and more likely to have hypertension, diabetes, and renal failure, with an overall lower J\u2010CTO score. Women showed a higher procedural success rate (adjusted OR [aOR]\u2009=\u20091.115, confidence interval [CI]: 1.011\u20131.230, <jats:italic>p<\/jats:italic>\u2009=\u20090.030). Apart from previous myocardial infarction and surgical revascularization, no other significant gender differences were found among predictors of procedural success. Antegrade approach with true\u2010to\u2010true lumen techniques was more commonly used than retrograde approach in females. No gender differences were found regarding in\u2010hospital MACCEs (0.9% vs. 0.9%, <jats:italic>p<\/jats:italic>\u2009=\u20090.766), although a higher rate of procedural complications was observed in women, such as coronary perforation (3.7% vs. 2.9%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and vascular complications (1.0% vs. 0.6%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Women are understudied in contemporary CTO\u2010PCI practice. Female sex is associated with higher procedural success after CTO\u2010PCI, yet no sex differences were found in terms of in\u2010hospital MACCEs. Female sex was associated with a higher rate of procedural complications.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30616","type":"journal-article","created":{"date-parts":[[2023,3,8]],"date-time":"2023-03-08T15:11:06Z","timestamp":1678288266000},"page":"918-931","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Gender differences in percutaneous coronary intervention for chronic total occlusions from the ERCTO study"],"prefix":"10.1002","volume":"101","author":[{"given":"Alexandre","family":"Avran","sequence":"first","affiliation":[{"name":"Centre Hospitalier de Valenciennes Valenciennes France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Zuffi","sequence":"additional","affiliation":[{"name":"Cardiology Unit Saint Martin Private Hospital Center Caen 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Cardiovascular Medicine University of Palermo Palermo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Sianos","sequence":"additional","affiliation":[{"name":"AHEPA University Hospital Thessaloniki Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moussa","family":"Idali","sequence":"additional","affiliation":[{"name":"Cardiology Unit Saint Martin Private Hospital Center Caen France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Garbo","sequence":"additional","affiliation":[{"name":"Maria Pia Hospital GVM Care &amp; Research Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Gagnor","sequence":"additional","affiliation":[{"name":"Department of Invasive Cardiology Maria Vittoria Hospital Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriele","family":"Gasparini","sequence":"additional","affiliation":[{"name":"Department of Invasive Cardiology, Humanitas Clinical and Research Center IRCCS Rozzano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Bufe","sequence":"additional","affiliation":[{"name":"Heart Center Krefeld University Witten\/Herdecke Witten Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leszek","family":"Bryniarski","sequence":"additional","affiliation":[{"name":"II Department of Cardiology and Cardiovascular Interventions, Institute of Cardiology Jagiellonian University Medical College Krak\u00f3w Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Artis","family":"Kalnins","sequence":"additional","affiliation":[{"name":"Clinic of Cardiovascular Diseases Riga East Clinical University Hospital Riga 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