Late-breaking Clinical Research Reveals Advances in Chronic Total Occlusion (CTO) Care and Outcomes Based on Data from More than 10,000 Patients Worldwide

May 20, 2022

MHIF is coordinating center for PROGRESS-CTO registry, which began in 2012 under the leadership of Dr. Emmanouil Brilakis, to advance care for CTO patients around the world

MINNEAPOLIS – May 20, 2022  The Minneapolis Heart Institute Foundation® (MHIF) presented today late-breaking clinical research showcasing advanced outcomes over the last 10 years with cutting-edge treatment strategies for serious, chronic total occlusions (CTOs), the most complex, total blockages in the coronary arteries. The presentation at the Society for Cardiovascular Angiography and Interventions (SCAI) 2022 Scientific Sessions highlighted an impressive milestone reached with more than 10,000 patients in the PROGRESS-CTO registry (PROspective Global REgiStry for the Study of CTO interventions).

This research initiative was created in 2012 as a collaborative effort for physicians around the world using percutaneous coronary intervention (PCI) techniques to treat CTOs. Dr. Emmanouil Brilakis is the Global Study Chairman and Principal Investigator and MHIF is the coordinating center for the research.

“Many patients have been reluctant to undergo these procedures because of concerns of low success and high complication rates, but this study shows the success is very high at experienced centers,” said Spyridon Kostantinis, MD, MHIF Research Scholar and lead author of the presentation at SCAI 2022. “Since the research registry was created in 2012, we have validated the increasing success in the efficiency of CTO-PCI in recent years without any changes in major adverse cardiac events.”

“The PROGRESS-CTO research contributes to the understanding of the rapid evolution of CTO-PCI techniques and technologies,” said Emmanouil Brilakis, MD, PhD, interventional cardiologist and chairman of the MHIF Center for Coronary Artery Disease. “We’re still not at 100 percent success with zero complications, which is the ultimate goal and also reinforces there is still room for innovation, in both technique and technology.”

Many CTO patients are faced with limited options because of the complexity of the treatment techniques. The PROGRESS-CTO research examined the clinical and angiographic characteristics and procedural outcomes of 10,249 CTO-PCIs performed in 10,019 patients at 40 centers around the world between 2012 and 2022. Highlights of the data presented:

  • Technical and procedural success rates were high (86 percent and 85 percent, respectively) and increased over time (p for trend<0.001), despite the high complexity of the lesions
  • Overall incidence of in-hospital major adverse cardiac events was 2.1 percent
  • Mean age was 64±10 years and 81 percent of the patients were men
  • Complexity of patients in study indicated by high prevalence of prior PCI (62 percent), prior coronary artery bypass graft surgery (29 precent), and diabetes mellitus (43 percent)
  • Over a 10-year period, successful CTO-PCI rates have increased to a high level with improved efficiency

“The PROGRESS-CTO registry contributes to the knowledge base of CTO-PCI operators and provides insights into procedural strategies and outcomes for CTO-PCIs, which will help improve access for all patients over time,” said Bavana Rangan, BDS, MPH, program director of the MHIF Center for Coronary Artery Disease and Global Director of the registry since inception.

About PROGRESS-CTO and the MHIF Center for Coronary Artery Disease

Previously, a CTO – an artery that is completely blocked for more than three months – could not be treated without invasive bypass surgery. Through innovative percutaneous techniques (performed through a needle stick through the leg or arm), interventional cardiologists are improving the outcomes of PCI, making it a rewarding option for many patients who are experiencing symptoms related to their CTO. Interventional cardiologists now are able to gently steer special guide wires and catheters across the blockages, which are then opened using stents.

PROGRESS-CTO is an ongoing contemporary, multi-center global registry of more than 10,000 CTO-PCIs performed worldwide at 63 participating hospitals in 9 countries, with 76 manuscripts published to date. The study goal is to provide novel insights into the most complex type of CTO-PCIs through rigorous study of techniques and outcomes across a varied group of operators and medical practices.

MHIF’s Center for Coronary Artery Disease works to decrease the burden of CAD through research, innovation and education. Coronary artery disease remains the leading cause of death in the developed world.


About Minneapolis Heart Institute Foundation®

The Minneapolis Heart Institute Foundation (MHIF) strives to create a world without heart and vascular disease. To achieve this bold vision, it is dedicated to improving the cardiovascular health of individuals and communities through innovative research and education.

Scientific Innovation and Research – MHIF is a recognized leader across all specialties of heart and vascular research. Each year, MHIF leads more than 200 research studies with more than 2,200 patients and publishes more than 220 articles to share learnings from research. MHIF research has improved the standard of care around the world through protocols like Level One for heart attack, which significantly improved outcomes and survival for patients.

Education and Outreach – MHIF provides more than 11,000 hours of education each year putting its research into practice to improve outcomes among health care providers. This commitment extends to patients and caregivers through a number of community health and education events to raise awareness of heart care and research, engaging individuals in their own health.

The Minneapolis Heart Institute Foundation’s work is funded by generous donors and sponsors and engages in cutting-edge research initiatives with its physician partners from the Minneapolis Heart Institute® at Abbott Northwestern Hospital and at 38 community sites across Minnesota and western Wisconsin. For more information, please visit


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