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Year : 2019  |  Volume : 32  |  Issue : 3  |  Page : 868-875

Clinical and angiographic predictors of success in chronic total occlusion coronary angioplasty

1 Department of Cardiology, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt
2 Department of Cardiology, Kobry El Kobba Military Hospital, Cairo, Egypt

Correspondence Address:
Ahmad M Mahmoud Elsheikh
Department of Cardiology, Kobry El Kobba Military Hospital, 14 Elobour St., Mansheyat Alsadat, Cairo
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mmj.mmj_229_15

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Objective The aim of this study was to define the preinterventional parameters for procedural success of chronic total occlusion (CTO) coronary angioplasty. Background CTOs are encountered in 15–30% of patients undergoing coronary angiography. Compared with failed CTO angioplasty, successful CTO angioplasty has been associated with improvement in angina and left ventricular function and increased survival. Compared with intervention of nonoccluded stenoses, the recanalization of CTOs requires expert operator skills, increased procedural time, and increased radiation exposure to the patient, physician, and catheterization laboratory staff. Materials and methods This prospective study was conducted from April 2014 to March 2015 in Kobry El Kobba Military Hospital and included 30 patients with CTO of more than 1-month duration having significant angina (class III/IV) or recent acceleration of previously chronic stable angina. Clinical and angiographic variants were listed, and rate of success and failure of each was calculated after CTO angioplasty trial. Results There were 25 successful angioplasty cases. There was no significant affection of the different clinical variants and risk factors on the success rate. On the contrary, some of the angiographic variants showed a significant affection on the success and failure rates. The criteria of failure were difficult antegrade and retrograde wiring, unhealthy donor vessel, blunt calcified distal cap, and no continuous collaterals. Conclusion The success rate of CTO percutaneous coronary intervention mainly depends on certain angiographic factors. The clinical factors, although not statistically significant, play a crucial role in decision planning of CTO percutaneous coronary intervention.

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