{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T07:03:08Z","timestamp":1790665388594,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The anatomical location of left anterior descending artery (LAD) chronic total occlusion (CTO) may influence procedural complexity and technical success beyond conventional CTO scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We evaluated the association between LAD CTO location and procedural characteristics and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Consecutive patients undergoing LAD CTO percutaneous coronary intervention at three centers between 2019 and 2026 were classified as having ostial, proximal, or mid\/distal CTOs. Lesion complexity, crossing strategy, resource utilization, and in\u2010hospital outcomes were compared. Multivariable logistic regression was adjusted for clinical characteristics and either the J\u2010CTO or EuroCTO score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 2157 CTO procedures, 644 involved the LAD: 81 ostial, 144 proximal, and 419 mid\/distal lesions. Ostial CTOs had greater anatomical complexity and required a retrograde approach more frequently than proximal and mid\/distal lesions (43.2% vs. 20.1% vs. 14.1%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). They were also associated with longer procedures, greater guidewire use, and higher contrast volume. Technical success was lower in ostial lesions (77.8% vs. 89.6% vs. 92.6%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), whereas in\u2010hospital major adverse cardiovascular events were similar. Ostial location remained independently associated with lower technical success after adjustment for the J\u2010CTO score (OR, 0.43; 95% CI, 0.21\u20130.87;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019) or EuroCTO score (OR, 0.41; 95% CI, 0.20\u20130.84;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Ostial LAD CTOs require retrograde strategies more often and have lower technical success despite adjustment for established CTO scores.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70922","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:20:46Z","timestamp":1790662846000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Impact of Location on the Outcomes of Left Anterior Descending Artery Chronic Total Occlusion Percutaneous Coronary Intervention"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-4628-6672","authenticated-orcid":false,"given":"Sefa","family":"Sural","sequence":"first","affiliation":[{"name":"Toros University Mersin T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9225-925X","authenticated-orcid":false,"given":"Ahmet Seyfeddin","family":"Gurbuz","sequence":"additional","affiliation":[{"name":"Department of Cardiology Necmettin Erbakan University Konya 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T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6422-3607","authenticated-orcid":false,"given":"Gokhan","family":"Avci","sequence":"additional","affiliation":[{"name":"Toros University Mersin T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6256-3771","authenticated-orcid":false,"given":"Emre","family":"Pacac\u0131","sequence":"additional","affiliation":[{"name":"Department of Cardiology Osmaniye Training and Research Hospital Osmaniye T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2508-6707","authenticated-orcid":false,"given":"Omer","family":"Bedir","sequence":"additional","affiliation":[{"name":"Department of Cardiology Adana City Training and Research Hospital Adana 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