Global status and trends in coronary chronic total occlusion over the period 2000–2023: a bibliometric analysis

Abstract

Background and purpose: Chronic total occlusion (CTO) affects 25% to 30% of individuals with coronary heart disease (CHD), posing significant challenges in percutaneous revascularization. This study investigates the advancement sand research trends in CTO by analyzing publication contributions from diverse countries, institutions, journals, and authors. Methods: We conducted a comprehensive literature review of CTO publications spanning from 2000 to 2023, utilizing the Web of Science Core Collection (WoSCC). Articles included were limited to those published in English. Research trends in the field were analyzed using CiteSpace 6.2.R4 (Chaomei Chen, Drexel University, Philadelphia, PA, USA) and VOSviewer 1.6.19 (Leiden University, Leiden, The Netherlands). Results: A total of 2,202 articles related to CTO were identified. The United States (US) emerged as the top contributor with 438 papers, followed by China with 305 papers, and Italy with 185 papers. Leading institutions included the US Department of Veterans Affairs with 353 publications, and Minneapolis Heart Institute Foundation with 217 publications. The Journal of the American College of Cardiology was the journal with the most publications in the field of CTO. Emmanouil S. Brilakis was identified as the most prolific author, while Gerald S. Werner had the highest average citation count. Cluster analysis highlighted chronic total occlusion percutaneous coronary intervention (CTO-PCI) as a focal area of research attention, indicating a promising trajectory for the field. Conclusions: This study provides a comprehensive analysis of the global research trends of CTO. The substantial increase in high-quality publications over the past 24 years highlights a promising future for the research and advancement of CTO-PCI.