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.
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.
Authors: Nicola Ryan; Nieves Gonzalo; Philip Dingli; Oscar Vedia Cruz; Pilar Jiménez-Quevedo; Luis Nombela-Franco; Ivan Nuñez-Gil; María Del Trigo; Pablo Salinas; Carlos Macaya; Antonio Fernandez-Ortiz; Javier Escaned Journal: Int J Cardiovasc Imaging Date: 2017-02-14 Impact factor: 2.357
Authors: Andreas Rolf; Gerald S Werner; Annika Schuhbäck; Johannes Rixe; Helge Möllmann; Holger M Nef; Constantin Gundermann; Christoph Liebetrau; Gabriele A Krombach; Christian W Hamm; Stephan Achenbach Journal: Int J Cardiovasc Imaging Date: 2013-06-23 Impact factor: 2.357
Authors: Georgios Christopoulos; R Michael Wyman; Khaldoon Alaswad; Dimitri Karmpaliotis; William Lombardi; J Aaron Grantham; Robert W Yeh; Farouc A Jaffer; Daisha J Cipher; Bavana V Rangan; Georgios E Christakopoulos; Megan A Kypreos; Nicholas Lembo; David Kandzari; Santiago Garcia; Craig A Thompson; Subhash Banerjee; Emmanouil S Brilakis Journal: Circ Cardiovasc Interv Date: 2015-07 Impact factor: 6.546