Predictors for Successful Angioplasty of Chronic Totally Occluded Coronary Arteries

• Published in: Journal of interventional cardiology Vol. 18; no. 1; pp. 1 - 7
• Main Authors: DONG, SHAOHONG, SMORGICK, YOSI, NAHIR, MENACHEM, LOTAN, CHAIM, MOSSERI, MORRIS, NASSAR, HISHAM, GOTSMAN, MERVYN S., HASIN, YONATHAN
• Format: Journal Article
• Language: English
• Published: 350 Main Street , Malden , MA 02148-5020 , USA , and P.O. Box 1354, Garsington Road , Oxford OX4 2DQ , UK Blackwell Science Inc 01.02.2005
• Subjects: Angioplasty, Balloon, Coronary; Coronary Disease - therapy; Female; Forecasting; Humans; Male; Middle Aged; Treatment Outcome
• ISSN: 0896-4327; 1540-8183
• DOI: 10.1111/j.1540-8183.2005.00390.x

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.