Immediate and long-term outcome of recanalization of chronic total coronary occlusions.
Eighty-three consecutive patients with 85 coronary total occlusions undergoing coronary angioplasty were retrospectively studied. Patients were divided into two groups according to the occlusion age that was < 30 days (subacute total occlusion [STO]: 25 patients; range 1-30 days) or > 30 days (chronic total occlusion [CTO]: 58 patients; range 3-144 months). All procedures were carried out using a hydrophilic guidewire. Clinical success, consisting of crossing the lesion, balloon dilatation, stent deployment without complications, was 96% in STO and 81% in CTO. Multiple stepwise logistic regression analysis identified a family history of coronary artery disease (CAD), left anterior descending and right coronary artery occlusions as independent predictors of a successful procedure. No major events occurred during or immediately after the angioplasty. After a mean follow-up of 24 +/- 2 months, no difference was found in survival or freedom from myocardial infarction or target vessel revascularization among the STO and CTO patients. Successful recanalization by using a hydrophilic guidewire was achieved in a high percentage of chronic total occlusions with a low incidence of complications and a satisfactory late clinical outcome. Family history of CAD and occlusion of left anterior descending or right coronary arteries are independent predictors of procedural success.
Division of Cardiology, Federico II University, Via S. Pansini 5, 80131 Naples, Italy. piscione@unina.it
Federico
F
Piscione
Gennaro
G
Galasso
Anton Giulio
AG
Maione
Alfonso
A
Pisani
Paolo
P
Golino
Dario
D
Leosco
Ciro
C
Indolfi
Massimo
M
Chiariello
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods; D002908:Chronic Disease; D003251:Constriction, Pathologic / Q000628:therapy; D003327:Coronary Disease / Q000473:pathology / Q000628:therapy*; D023903:Coronary Restenosis / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome