Clinical and angiographic predictors of successful percutaneous coronary intervention in chronic total coronary occlusions

Abstract

Percutaneous coronary intervention (PCI) of chronic total occlusions (CTO) is considered one of the most challenging procedures I interventional cardiology & may lead to multiple complications. Multiple factors may adversely influence the success rate of the procedure however the benefits of the revascularization usually outweigh the risks of the procedure. Is to assess the clinical and angiographic predictors of successful PCI in CTO of native coronary artery. 100 patients who have referred to Damanhur teaching hospital for elective PCI of CTO, mean age was 53.9 ± 8.49, were assessed clinically & angiographically with reporting the procedure outcome among them. The overall success rate was 83% mostly in LAD (82%) leas in the LCX (75%), there was no significant affection of the clinical & demographic factors on the success rate of the PCI however angiographic characteristics including stump shape, calcifications, presence of bridging collaterals, side branch at occlusion point, vessel tortuosity, site of the lesion, length of the lesion and vessel diameter were strong predictors for success in the study. The duration of occlusion, length of the lesion, vessel diameter, stump shape, presence of bridging collaterals, side branch at occlusion point, calcifications, vessel tortuosity and lesion location were independent predictors of successful CTO revascularization, whereas patient's characteristics and clinical risk factors are not.