Jun 3, 2026 · 9 min · 3 segments
Ruben de Winter and C. Michael Gibson compare clinical outcomes of native vessel versus SVG PCI for patients with prior CABG.
Ruben De WinterGuest
Michael GibsonHost
And first of all, I would like to say I'm honored to be able to discuss the first results of the PROC-TO trial today here with you and naturally on behalf of the PROC-TO trial investigators.
Well, I think the PROC-TO trial is about some of the key challenges that we face in managing post-catch patients.
We know that long-term efficacy of bypass graft surgery is limited by both bypass graft failure and progression of disease in the native coronary arteries.
And as a result, there's a substantial number of patients that present with recurrent angina symptoms and ischemia affecting up to six out of 10 patients at 15 years after bypass surgery.
And many of these patients return to the cath lab for repeat coronary angiography and further revascularization therapy.
And this is a patient population that is high risk and complex because patients are typically older, more frail.
They have a high prevalence of risk factors and comorbidities, as well as complex and more advanced coronary lesion morphology, which is driven by, on the one hand, disease by post grafts with viable plaques.
And on the other hand, extensive but also accelerated disease in the native coronary arteries resulting in long and calcified lesions and a high prevalence of chronic total coronary occlusions, which is reported in over 50% of these patients.
And that's why we set out to do the PROPTOR trial, which is the first randomized study comparing a strategy of native vessel PCI with 7-sphagnum graft PCI in patients with prior cabbage who present with a bypass graft failure and an indication for repeat percutaneous repascularization as determined by the HART team.
And the primary endpoint for this analysis was MACE, so major adverse cardiovascular events.
And that was a composite of all-cause mortality, non-fatal targets, coronary territory myocardial infarction, and clinically driven target coronary territory revascularization.
And first of all, I would like to say I'm honored to be able to discuss the first results of the PROC-TO trial today here with you and naturally on behalf of the PROC-TO trial investigators.
Well, I think the PROC-TO trial is about some of the key challenges that we face in managing post-catch patients.
We know that long-term efficacy of bypass graft surgery is limited by both bypass graft failure and progression of disease in the native coronary arteries.
And as a result, there's a substantial number of patients that present with recurrent angina symptoms and ischemia affecting up to six out of 10 patients at 15 years after bypass surgery.
And many of these patients return to the cath lab for repeat coronary angiography and further revascularization therapy.
And this is a patient population that is high risk and complex because patients are typically older, more frail.
They have a high prevalence of risk factors and comorbidities, as well as complex and more advanced coronary lesion morphology, which is driven by, on the one hand, disease by post grafts with viable plaques.
And on the other hand, extensive but also accelerated disease in the native coronary arteries resulting in long and calcified lesions and a high prevalence of chronic total coronary occlusions, which is reported in over 50% of these patients.
And that's why we set out to do the PROPTOR trial, which is the first randomized study comparing a strategy of native vessel PCI with 7-sphagnum graft PCI in patients with prior cabbage who present with a bypass graft failure and an indication for repeat percutaneous repascularization as determined by the HART team.
And the primary endpoint for this analysis was MACE, so major adverse cardiovascular events.
And that was a composite of all-cause mortality, non-fatal targets, coronary territory myocardial infarction, and clinically driven target coronary territory revascularization.
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