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Predictors for Successful Angioplasty of Chronic Totally Occluded Coronary Arteries

Predictors for Successful Angioplasty of Chronic Totally Occluded Coronary Arteries Aims: Reevaluation of clinical and angiographic predictors for percutaneous recanalization of coronary chronic total occlusion (CTO) using current techniques with conventional PTCA wires and balloons. Methods and 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. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Interventional Cardiology Wiley

Predictors for Successful Angioplasty of Chronic Totally Occluded Coronary Arteries

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References (32)

Publisher
Wiley
Copyright
Copyright © 2005 Wiley Subscription Services, Inc., A Wiley Company
ISSN
0896-4327
eISSN
1540-8183
DOI
10.1111/j.1540-8183.2005.00390.x
pmid
15788046
Publisher site
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Abstract

Aims: Reevaluation of clinical and angiographic predictors for percutaneous recanalization of coronary chronic total occlusion (CTO) using current techniques with conventional PTCA wires and balloons. Methods and 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.

Journal

Journal of Interventional Cardiology – Wiley

Published: Feb 1, 2005

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