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.
Piscione
Federico
F
Division of Cardiology, Federico II University, Via S. Pansini 5, 80131 Naples, Italy. piscione@unina.it
Galasso
Gennaro
G
Maione
Anton Giulio
AG
Pisani
Alfonso
A
Golino
Paolo
P
Leosco
Dario
D
Indolfi
Ciro
C
Chiariello
Massimo
M
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