Funding issues due to the pandemic

Design: Single center, double-blind, sham-controlled trial that will randomize symptomatic patients with a coronary chronic total occlusion (CTO) to CTO percutaneous coronary intervention (PCI) or a sham procedure. All patients will receive optimal medical therapy.

Treatment:CTO PCI, as per standard clinical practice.

Control: Patients randomized to sham-procedure will undergo only bilateral arterial access, without angiography or PCI being performed.

Secondary Endpoints: (1) Greater improvement in SAQ-7 Summary scores during the entire duration of follow-up (6 months) using a repeated measures analysis (2) Greater improvement in individual components of patients' health status (3) Greater improvement in exercise capacity (4) Similar incidence of major adverse cardiac events (MACE), both peri-procedural and long-term

Inclusion Criteria:

• Age 18 years or greater
• Willing and able to give informed consent. The patients must be able to comply with study procedures and follow-up.
• Referred for clinically-indicated CTO PCI
• Optimal medical therapy (at least two anti-anginal medications at maximum tolerated doses, aspirin, and statin)

Exclusion Criteria:

• Coexisting conditions that limit life expectancy to less than 6 months or that could affect a patient's compliance with the protocol
• Recent (<7 days) acute myocardial infarction
• Patient has no symptoms related to the CTO
• Known allergy to aspirin or clopidogrel
• Increased risk of bleeding (need for warfarin, oral Xa inhibitor, or thrombin inhibitor administration, recent [within 30 days] major bleed, known bleeding diathesis or coagulation disorder)
• Positive pregnancy test or breast-feeding
• Chronic kidney disease, defined as serum creatinine > 2.5 mg/dL
• Severe peripheral arterial disease limiting exercise capacity