Long-Term Vascular Function in CTO Recanalization: A Randomized Clinical Trial of Ticagrelor vs. Clopidogrel

•Coronary vascular function immediately after CTO recanalization is poor and may be partially improved by ticagrelor prePCI loading dose.•Ticagrelor maintaining treatment for 12-month may reduce this vascular dysfunction with higher coronary blood flow as compared to clopidogrel.•Clopidogrel treatment exhibits a significant increase in coronary blood flow at follow-up, which does not reduce the gap from ticagrelor patients.