Chronic total occlusion percutaneous coronary intervention: Short and medium term results - 17/04/19
Résumé |
Introduction |
Coronary chronic total occlusion (CTO) angioplasties are considered the most complex of angioplasties requiring experienced operators as well as many specific materials and techniques.
Purpose |
This study aims to identify the predictors of success or failure of CTO angioplasty and to evaluate the short- and medium-term results of this procedure.
Material and methods |
This study is a single-centric retrospective comparative study including patients who underwent CTO angioplasty in the cardiology “A” department at Fattouma-Bourguiba Hospital during the period between January and 2008 and December 2015.
Results |
Our study included 200 patients with attempt of CTO angioplasty. The mean age was 63±8.63 years and the mean number of cardio-vascular risk factors was 2.67. Acute coronary syndrome was the main indication (57.5%) for coronarography. A multi-truncal coronary status was reported in 53.5% of the cases. The mean J-CTO score was 1.42±1.3 and 44% of lesions were estimated difficult to very difficult. The anterograde approach has been the most used technique. The angiographic success of ATL has been reported in 106 patients (53%). DES were implanted in 69.9% of cases. The leading cause of angioplasty failure was the impossibility to cross the lesion by the wire. The procedural complications occurred in 11.5% of cases. The independent predictors of ATL failure were: dyslipidaemia, a bending>45 degrees (P<0.001), a diameter of the occluded vessel<3mm (P<0.001) and JCTO score≥2 (P<0.001). Short- and medium-term clinical follow-up showed that the success of ATL, compared to failure, decreased significantly the rate of angina recurrence (P<0.001), re-hospitalization (P=0.012) and major adverse cardio-vascular events “MACE” (P=0.006), but without significant impact on mortality.
Conclusion |
The results of our study showed a clinical benefit of CTO angioplasty in case of success and demonstrated once more many failure predicting angiographic factors.
Le texte complet de cet article est disponible en PDF.Plan
Vol 11 - N° 1P2
P. e286 - avril 2019 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?