{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T16:59:22Z","timestamp":1785257962988,"version":"3.55.0"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,7,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Aorto\u2010ostial chronic total occlusions (CTOs) of the right coronary artery (RCA) represent a particularly complex subset of CTO percutaneous coronary interventions (PCI), yet dedicated data remain limited. We aimed to evaluate technical outcomes of aorto\u2010ostial versus non\u2013aorto\u2010ostial RCA CTO PCI and to identify predictors of failure in RCA aorto\u2010ostial lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients undergoing RCA CTO PCI between 2016 and 2024 and enrolled in the ERCTO (European Registry of Chronic Total Occlusion) registry were included in the present analysis. The primary end point was technical success. Multivariable logistic regression was used to identify independent predictors of technical failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      A total of 26\u2009374 patients undergoing RCA CTO PCI were included in the analysis, of whom 2850 had aorto\u2010ostial and 23\u2009524 non\u2013aorto\u2010ostial lesions. Technical success was lower in aorto\u2010ostial compared with non\u2013aorto\u2010ostial lesions (79.6% versus 89.7%;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). Aorto\u2010ostial location was independently associated with technical failure (adjusted odds ratio [OR], 1.85;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). In multivariable analysis restricted to aorto\u2010ostial CTOs, stumpless proximal cap morphology (adjusted OR, 2.44,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), moderate\u2010to\u2010severe tortuosity (adjusted OR, 2.13\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), severe calcification (adjusted OR, 1.92,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), and peripheral artery disease (adjusted OR, 1.57\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001) were independently associated with technical failure. In\u2010hospital major adverse cardiac and cerebrovascular events rates were low and did not differ significantly between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Aorto\u2010ostial RCA CTO PCI has a significantly lower technical success despite extensive use of advanced techniques. Technical failure is driven primarily by lesion\u2010specific anatomical features, underscoring the need for dedicated strategies and refined risk stratification tailored to aorto\u2010ostial anatomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.126.051613","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T10:58:08Z","timestamp":1784285888000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Aorto\u2010Ostial Right Coronary Artery Chronic Total Occlusion Percutaneous Coronary Intervention: Technical Outcomes and Predictors of Failure From the ERCTO Registry"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4374-0389","authenticated-orcid":false,"given":"Ioannis","family":"Skalidis","sequence":"first","affiliation":[{"name":"HFR \u2013 Fribourg Cantonal Hospital and University","place":["Fribourg, Switzerland"]},{"name":"Institut Cardiovasculaire Paris Sud (ICPS)","place":["Massy, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0515-639X","authenticated-orcid":false,"given":"Luca","family":"Esposito","sequence":"additional","affiliation":[{"name":"Institut Cardiovasculaire Paris Sud (ICPS)","place":["Massy, France"]},{"name":"Federico II University of Naples","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1359-9185","authenticated-orcid":false,"given":"Thomas","family":"Hovasse","sequence":"additional","affiliation":[{"name":"Institut Cardiovasculaire Paris Sud (ICPS)","place":["Massy, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Laforgia","sequence":"additional","affiliation":[{"name":"Institut Cardiovasculaire Paris Sud (ICPS)","place":["Massy, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrei G.","family":"Florescu","sequence":"additional","affiliation":[{"name":"Institut Cardiovasculaire Paris Sud (ICPS)","place":["Massy, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7431-6305","authenticated-orcid":false,"given":"Stephane","family":"Champagne","sequence":"additional","affiliation":[{"name":"Institut Cardiovasculaire Paris Sud (ICPS)","place":["Massy, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald S.","family":"Werner","sequence":"additional","affiliation":[{"name":"Medizinische Klinik I, Klinikum Darmstadt","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Garbo","sequence":"additional","affiliation":[{"name":"Maria Pia Hospital, GVM Care & Research","place":["Turin, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo R.","family":"Galassi","sequence":"additional","affiliation":[{"name":"University Hospital \u201cP. Giaccone\u201d","place":["Palermo, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2344-6705","authenticated-orcid":false,"given":"Roberto","family":"Diletti","sequence":"additional","affiliation":[{"name":"Erasmus MC Cardiovascular Institute, Thorax Center","place":["Rotterdam, the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6454-1944","authenticated-orcid":false,"given":"Nicolas","family":"Boudou","sequence":"additional","affiliation":[{"name":"Clinique St. Agustin","place":["Bordeaux, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele L.","family":"Gasparini","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4342-5952","authenticated-orcid":false,"given":"Omer","family":"Goktekin","sequence":"additional","affiliation":[{"name":"Memorial Bah\u00e7elievler Hospital","place":["Istanbul, Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1505-9369","authenticated-orcid":false,"given":"Pierfrancesco","family":"Agostoni","sequence":"additional","affiliation":[{"name":"HartCentrum, Ziekenhuis Netwerk Antwerpen Middelheim","place":["Antwerp, Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4461-2055","authenticated-orcid":false,"given":"Carlo","family":"di Mario","sequence":"additional","affiliation":[{"name":"Careggi University Hospital","place":["Florence, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5970-0093","authenticated-orcid":false,"given":"Michael","family":"Behnes","sequence":"additional","affiliation":[{"name":"University Medical Centre Mannheim","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Vadal\u00e0","sequence":"additional","affiliation":[{"name":"University Hospital \u201cP. 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