Background: The clinical benefit of chronic total occlusions (CTO) recanalisation is still being discussed. The aim of our study is to analyse long-term clinical results of CTO recanalisation drug-eluting stent implantation.

Methods: Patients were divided into groups: main group(A) consisted of patients with successful revascularization(n-321, mean age 58±9 years)compared with patients(control group B), who received medical therapy(n-264, mean age 61±10 years). The average follow-up was 1095±36 days. Predictors of survival without coronary events (angina+myocardial infarction+coronary death) and chronic heart failure reoccurrence were analyzed employing Cox proportional hazards model.

Results: The frequency of angina and chronic heart failure reoccurrence was lower in the group with successful revascularization of CTO (p<0.05). According to the functional tests, after a period of 3 years of follow-up, the frequency of positive exercise tolerance tests was higher in group B(p<0.05). Patients in group A required less antianginal therapy (p<0.05). Analysis of coronary events predictors in both groups revealed that the main factors negatively affecting the long-term prognosis are: patient’s age over 65 years and diabetes mellitus (p=0.006).The left anterior descending artery lesion (p=0.001) is the main factor that increases the risk of heart failure progression in the long run in group B. 3-year survival without coronary events was higher in group A. Survival without progression of chronic heart failure by the end of the 3d-year of observation period was also higher in group A.

Conclusion: Revascularization of CTO of coronary arteries is effective and feasible. Endovascular recanalization of CTO with drug-eluting stent implantation can improve the long-term prognosis.