Clinical, Electrocardiographic, and Procedural Characteristics of Patients With Coronary Chronic Total Occlusions

Abstract

Percutanous coronary intervention for chronic total occlusion lesions is technically difficult despite equipment advances.In this study, clinical ,electrocardiography and coronary angiographic data of (100) patients with chronic total occlusion lesion who underwent percutanous coronary intervention at the Iraqi center for heart diseases were prospectively analyzed. Chronic total occlusion was diagnosed from clinical events including myocardial infarction or worsening of their symptoms or previous angiography.The success rate of PCI was significant in lesion shorter than 15 mm , presence of tapered stump, angulations less than 45 degree, duration less than 3 months and TIMI 1 flow grade ( p values were significant) . Presence of Q wave was associated with severe angina , decreased left ventricular ejection fraction, critical lesions other than chronic total occlusion , T wave inversion and more regional wall motion abnormality (p values were significant). The most common cause of procedural failure was inability of guide wire to cross through the totally occluded segment.The procedural success rate was related to the length of lesion ,degree of angulations, stump morphology, duration of occlusion and TIMI flow grade, The procedural success rate was not related to the presence of pathological Q wave, which were associated with sever angina ,decreased left ventricular ejection fraction, critical lesions other than chronic total occlusion, T wave inversion and more regional wall motion abnormality.