ACC 26: ORBITA-CTO: PCI Versus Placebo for Chronic Total Occlusion in Stable Angina

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American College of Cardiology Congress 2026 - Dr Sarosh Khan and Dr John Davies (Essex Cardiothoracic Centre, Basildon, UK) join us to discuss results from the ORBITA-CTO trial (NCT05142215; Mid and South Essex NHS Foundation Trust), a randomised, placebo-controlled study evaluating CTO PCI versus placebo for the relief of stable angina.

This double-blind, randomised, placebo-controlled pilot trial enrolled 50 patients with stable angina attributable to a single-vessel CTO, confirmed ischaemia in the CTO territory, and background optimal medical therapy. Patients were randomised to CTO PCI using contemporary techniques and drug-eluting stents, or a placebo procedure, with both groups remaining blinded throughout. The primary endpoint was change in angina symptom ordinal scale score at 24 and 26 weeks, with secondary endpoints including Seattle Angina Questionnaire domains, quality of life, dyspnoea, and exercise capacity measured by peak VO₂.

Findings were highly statistically significant, patients in the CTO angioplasty group were four times as likely to have improved angina scores as compared to the placebo group. Compared to placebo, patients in the intervention group also had a statistically significant improvement in quality-of-life scores, and reduced angina severity as assessed by physicians.


Recorded on-site at ACC 2026, New Orleans.


Editor: Jordan Rance
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