VIDEO: Disappointments, concerns stem from DECISION-CTO trial results

WASHINGTON — In this video, B. Hadley Wilson, MD, FACC, chair of the board of governors and secretary of the board of trustees of the American College of Cardiology and interventional cardiologist at Sanger Heart & Vascular Institute, Carolinas HealthCare System, offers perspective on the DECISION-CTO trial results presented at the ACC Scientific Session.

The randomized trial of patients with chronic total occlusion previously treated with medical therapy or surgery compared medical therapy vs. complex CTO PCI. There was no significant difference in outcomes between the groups over follow-up of more than 5 years.

“For those that are interventionalists, there may be some disappointment for the results of this trial because, essentially, it didn't show any mortality difference or overall differences in outcomes in those that had PCI and those that were treated medically,” Wilson said.

According to Wilson, a limitation of DECISION-CTO is that it started in 2010, and newer devices and techniques have been made available since then.

Additionally, he said, there may not have been a sufficient amount of patients who were followed for an adequate amount of time, making it difficult to see differences between treatments.

“It still remains, though, for these CTOs that PCI should be done for them to try and help relieve symptoms, and at this time we can’t really show that there's a mortality difference or benefit.”