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Supplementary Table S1: Baseline Characteristics and Interventions of Included Studies.

Study Year Design Centers, n Location Period Patients, n Age,

years

Male,

%

BMI, kg/m2

Diabetes,

%

Hypertension,

%

Dyslipidemia,

%

Finn.M.T14 2018 Non-RCT 1 US 2014-2016 157 64±9 87 NA 32 92 96

Sabbah.M15 2018 Non-RCT 1 Japan 2011-2012 157 69 86 25±4 10 19 16

Karacsonyi.J16 2018 RCT 11 US 2015-2017 246 66±10 82 31±7 37 88 89

Tajti.P1 2018 Non-RCT 20 US/Europe/Russia 2012-2017 3055 65±10 85 31±6 43 92 90

Hasegawa.K17 2017 Non-RCT 30 Japan 2012 323 NA NA NA NA NA NA

Song.L18 2017 Non-RCT 1 US 2014-2016 219 64±10 84 NA 36 93 96

Maeremans.J19 2017 Non-RCT 17 UK 2014-2015 1165 66±10 86 NA 26 61 67

Danek.Ba26 2016 Non-RCT 11 US 2012-2015 1288 66±10 84 NA 45 90 94

Azzalini.L20 2016 Non-RCT 3 Italy/Canada/Spain 2010-2016 792 NA NA NA NA NA NA

Wilson.WM21 2016 Non-RCT 7 UK 2012-2014 1156 65±10 79 29±5 25 NA NA

Muramatsu.T22 2014 Non-RCT 27 Japan 2010-2011 156 65±10 88 NA 35 67 71

Godino.C23] 2012 Non-RCT 1 Italy 2005-2008 355 61±9 87 NA 30 73 71

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Tanaka.H24 2010 Non-RCT 1 Japan 2005-2009 159 NA NA NA NA NA NA

Rathore.S25 2009 Non-RCT 1 Japan 2002-2008 358 65±10 85 NA 38 62 42

Study

Prior MI,

%

Prior PCI,

%

Prior CABG,

%

LVEF,

%

In-stent occlusion,

%

Target CTO vessel

Retrograde,

%

Prior CTO attempt,

%

DR techniques Outcomes included in meta-analysis LAD,

%

LCX,

%

RCA,

%

Finn.M.T14 33 70 35 53 NA 34 20 46 25 20 Crossboss/Stringray/rCART

Perforation; PMI; uTVR; J- CTO score; CTO occlusion length; Fluoroscopy time;

Contrast volume

Sabbah.M15 65 NA 4 NA NA 40 15 45 36 14 CART/rCART

Perforation; PMI; uTVR;

Mortality; CTO occlusion length; Fluoroscopy time;

Contrast volume

Karacsonyi.J16 43 NA 26 52 23 19 16 64 17 19 Crossboss

Perforation; PMI; Stroke;

uTVR; Mortality

Tajti.P1 46 65 32 54 17 24 20 55 24 20 NA

Perforation; PMI; Stroke;

uTVR; Mortality

Hasegawa.K17 NA NA NA NA NA NA NA NA 25 NA rCART

Perforation; PMI; uTVR;

Mortality; Fluoroscopy time;

Contrast volume

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Song.L18 34 69 33 16（EF<40%） NA 29 21 49 28 21 Crossboss/Stringray/rCART

Perforation; PMI; Stroke;

uTVR; Mortality; J-CTO score;

CTO occlusion length;

Fluoroscopy time; Contrast volume

Maeremans.J19 38 56 17 9（EF<55%） NA NA NA NA 25 NA Crossboss/Stringray/rCART J-CTO score

Danek.Ba26 42 65 34 28（EF<55%） 14 23 20 57 NA 18 ADR (CrossBoss54%)

J-CTO score; CTO occlusion length; Fluoroscopy time;

Contrast volume

Azzalini.L20 NA NA NA NA NA 28 20 52 33 NA

ADR (CrossBoss/Stingray42%);

RDR (rCART84%)

Perforation; Stroke; uTVR;

Mortality; J-CTO score

Wilson.WM21 55 63 21 33（EF<55%） 8 27 17 56 31 27

ADR (CrossBoss and Stingray);

RDR (rCART84%)

Perforation; PMI; uTVR;

Mortality

Muramatsu.T22 40 NA 11 NA NA 29 12 59 63 20 rCART

Perforation; PMI; uTVR;

Mortality; CTO occlusion length

Godino.C23 51 50 21 53±9 12 29 25 46 NA 18 Guided-STAR Perforation; PMI

Tanaka.H24 NA NA NA NA NA NA NA NA 100 NA r-CART PMI; Stroke; uTVR; Mortality

Rathore.S25 90 30 14 NA NA 31 16 48 0 NA CART

Perforation; PMI; uTVR;

Mortality; CTO occlusion length; Fluoroscopy time

Abbreviations: BMI: body mass index; RCT: randomized controlled trial; CTO: chronic total occlusion; PCI: percutaneous coronary intervention; DR: dissection and re-entry; ADR: antegrade dissection and re-entry;

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RDR: retrograde dissection and re-entry; STAR: subintimal tracking and re-entry; LAST: limited antegrade subintimal tracking; rCART: reverse controlled antegrade and retrograde tracking; MI: myocardial infarction;

CABG: coronary artery bypass graft; LVEF: left ventricular ejection fraction; LAD: left anterior descending; LCX: left circumflex artery; RCA: right coronary artery; PMI: periprocedural myocardial infarction; uTVR:

urgent target vessel revascularization.

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