title: Predictors for successful angioplasty of chronic totally occluded coronary arteries.
abstract: OBJECTIVE
  Reevaluation of clinical and angiographic predictors for percutaneous recanalization of coronary chronic total occlusion (CTO) using current techniques with conventional PTCA wires and balloons.
  
  
  RESULTS
  We studied 253 consecutive patients with 283 lesions who underwent attempted PTCA of CTO (mean time since occlusion 33 months, range 3-150 month). Immediate procedural success rate was 84.8% (95% CI = 80.3%-88.6%). Multiple clinical and angiographic characteristics were evaluated as possible predictors of success/failure. Multiple logistic regression analysis revealed that a tapered morphology (P < 0.001, OR = 6.1; 95% CI = 2.1-18.2), </=45 degree of angulations of the target artery (P < 0.03, OR = 4.5; 95% CI = 1.2-17.2), length of occlusion <15 mm (P < 0.001, OR = 3.4; 95% CI = 1.6-7.0), and the presence of multiple lesions in the target artery (P < 0.03, OR = 2.2; 95% CI = 1.1-4.4) were statistically significant independent predictors of procedural success. According to absence or presence of the various identified determinants of outcome, predicted procedural success rates varied between 26 and 98%.
  
  
  CONCLUSIONS
  Although the probability of immediate procedural success with percutaneous recanalization of coronary CTO using conventional PTCA is now high, a number of characteristics of the occlusive lesion represent significant modulators of success or failure. These factors should be utilized in the process of patients or lesions selection.
authors.affiliation: Cardiology Department, Hadassah Medical Center, Ein Kerem, Jerusalem, Israel.
authors.forename: Shaohong
authors.initials: S
authors.lastname: Dong
authors.forename: Yosi
authors.initials: Y
authors.lastname: Smorgick
authors.forename: Menachem
authors.initials: M
authors.lastname: Nahir
authors.forename: Chaim
authors.initials: C
authors.lastname: Lotan
authors.forename: Morris
authors.initials: M
authors.lastname: Mosseri
authors.forename: Hisham
authors.initials: H
authors.lastname: Nassar
authors.forename: Mervyn S
authors.initials: MS
authors.lastname: Gotsman
authors.forename: Yonathan
authors.initials: Y
authors.lastname: Hasin
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D003327:Coronary Disease / Q000628:therapy*; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome