{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T15:26:10Z","timestamp":1780500370983,"version":"3.54.1"},"reference-count":0,"publisher":"Pakistan Journal of Medical Sciences","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pak J Med Sci"],"abstract":"<jats:p>Objective: The current study aimed to review evidence on the effects of prior failed percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) on subsequent reattempted procedures.\nMethodology: Studies published on the databases of PubMed, Embase, Scopus, and Web of Science comparing outcomes of prior failed CTO-PCI with first-attempt CTO-PCI were included. Random-effects meta-analysis was conducted for baseline characteristics, success rates, and complications.\nResults: Six studies were included with 15,803 patients of which 3248 (20.6%) had prior failed PCI for CTO. Patients with prior failed CTO-PCI had significantly lower age, higher Japanese-CTO scores, higher incidence of tortuous vessels, increased contrast volume, and higher fluoroscopy time. The retrograde approach was more frequently used in prior failed cases. Meta-analysis showed that procedural (OR: 0.50 95% CI: 0.32, 0.77 I2=89%) and technical success (OR: 0.69 95% CI: 0.53, 0.88 I2=68%) was significantly lower in cases with prior failed CTO-PCI as compared to those undergoing first attempt CTO-PCI. There was no difference in the risk of major adverse cardiac events (OR: 1.14 95% CI: 0.62, 2.09 I2=47%) and individual complications between the two groups.\nConclusions: Evidence suggest that cases with prior failed CTO-PCI may have significantly lower procedural and technical success rates as compared to those undergoing first-attempt CTO-PCI. There may be no difference in the risk of complications between the two groups. High heterogeneity precludes strong conclusions. Further studies are needed to improve the quality of evidence.<\/jats:p>","DOI":"10.12669\/pjms.42.6.16250","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T14:46:56Z","timestamp":1780498016000},"page":"1550-1561","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of previous failure on subsequent procedural outcomes of chronic total occlusion percutaneous coronary intervention: A systematic review and meta-analysis"],"prefix":"10.12669","volume":"42","author":[{"given":"Weiqiang","family":"Sun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ailing","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Can","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4935","published-online":{"date-parts":[[2026,6,3]]},"container-title":["Pakistan Journal of Medical Sciences"],"original-title":[],"link":[{"URL":"https:\/\/www.pjms.org.pk\/index.php\/pjms\/article\/download\/16250\/11495","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.pjms.org.pk\/index.php\/pjms\/article\/download\/16250\/11495","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T14:46:57Z","timestamp":1780498017000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.pjms.org.pk\/index.php\/pjms\/article\/view\/16250"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,3]]},"references-count":0,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6,2]]}},"URL":"https:\/\/doi.org\/10.12669\/pjms.42.6.16250","relation":{},"ISSN":["1681-715X","1682-024X"],"issn-type":[{"value":"1681-715X","type":"electronic"},{"value":"1682-024X","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6,3]]}}}