Differences in the clinical and angiographic characteristics of chronic total occlusion lesions in the three major coronary arteries.
OBJECTIVE
The purpose of this study was to evaluate the differences in the clinical and angiographic characteristics of chronic total occlusion (CTO) lesions among the 3 major coronary arteries (LAD, LCx, and RCA).


BACKGROUND
The success rate of percutaneous coronary intervention (PCI) of CTO lesions is not uniform among the 3 major coronary arteries and this may be influenced by the differences in angiographic and clinical characteristics that may exists between them.


METHODS
We retrospectively evaluated clinical and angiographic characteristics of patients who underwent PCI of CTO lesions at our 2 centers between 2003 and 2010.


RESULTS
We analyzed 708 CTO-PCI procedures between 2003 and 2010. The CTO lesions were located in LAD: 222 (31.4%), LCx: 167 (23.6%), and RCA: 319 (45.0%). Patients with CTO in LAD had lower incidence of previous history of PCI and CABG compared to those with CTO lesions in LCx or RCA. In regard to angiographic findings, LAD lesions tended to have more side branches and blunt occlusion stump. The LCx lesions presented more frequently as a part of multivessel disease. RCA lesions were significantly longer, more severely angulated, and calcified. Good collateral circulations were more often encountered in the RCA. In regard to success rates, RCA showed lower procedural success rates (71.8%) followed by LAD (74.8%) and LCx (79.0%).


CONCLUSIONS
There were several differences in the clinical and angiographic characteristics of CTO lesions among the 3 major coronary arteries. These differences can explain the discrepancy in procedure success rates.
Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy; Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
Tasuku
T
Hasegawa
Cosmo
C
Godino
Sandeep
S
Basavarajaiah
Kensuke
K
Takagi
Ahmed
A
Rezq
Azeem
A
Latib
Chieffo
C
Alaide
Matteo
M
Montorfano
Mauro
M
Carlino
Antonio
A
Colombo
D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies