Farhan Faisal, Nadeem Hayat Mallick, Naresh Kumar, Syed Rizwan Bukhari, Muhammad Sohail, Syed Abdul Bari, Abdul Rehman Abid.
Technical success of percutaneous coronary intervention of chronic total occlusion.
J Cardiovascular Dis Jan ;10(2):39-43.

Objective: Objective: To evaluate the technical success of percutaneous coronary intervention(PCI) of chronic Objective: total occlusion (CTO). Materials and methods: Materials and methods: This observational study was conducted at the Cardiology Department, Materials and methods: Punjab Institute of Cardiology, Lahore from January to June 2010. Seventy patients fulfilling inclusion and exclusion criteria were studied. All PCIs of CTOs were performed by experienced cardiologists. A fluoroscopy time of 30 minutes was allocated to wire the lesion. The primary end point was procedural success. If the angioplasty guide wire failed to progress, or secondary end point occurred which was complications such as coronary dissection, perforation or hemodynamic instability the procedure was abandoned and declared unsuccessful. The procedure was concluded on achievement of the primary end point or any of the secondary end points. Results: Results: Mean age of patients was 52.7±9.9 years, mean height was 167.22 ±6.4 cm and mean weight Results: was 76.3±9 kg. Out of 70 patients 57(81.4%) were males and 13(18.6) females. Regarding coronary artery risk factors 22(31.4%) were diabetic, 39(55.7%) hypertensive, 34(48.6%) smokers, 17(24.3%) with family history of ischemic heart disease and 13(13%) had previous history of ischemic heart disease. Diseased artery was left anterior descending (LAD) in 32(45.7%), left circumflex (LCX) in 9(12.9%) and right coronary artery (RCA) in 29(41.4%). Regarding lesion characteristics of CTO distal vessels were visualized in 56 (80%), antegrade flow was elicited in 45(64.3%), retrograde flow in 25(35.7%), and calcification was observed in 9(12.9%) patients. Stump shape was tapering in 46(65.7%) and flat in 24(34.3%). Collaterals were present in 36(51.4%), bridging collaterals were observed in 13(18.6%) and side branch within 2 mm of lesion was present in 42(60%). Length of leison was <10mm in 4(5.7%), 10-20mm in 30(42.9%) and >20mm in 36(51.4%) patients. Guide wire crossed the lesion with balloon support in 54(77%) pateints. Thrombolysis in myocardial infarction (TIMI) III flow was achieved in 54(77%) and technical success was 54(77%). Residual stenosis of >30% was observed in 16(22.9%). Conclusion: Conclusion: Percutaneous coronary intervention is a safe and useful procedure for the revascularization Conclusion: of coronary chronic total occlusion lesions. Further more the radial artery might be a feasible vascular route in PCI for CTO. Key Words: Coronary artery disease; Chronic total occlusion; Percutaneous coronary intervention; ords: Bridging collaterals; Tapering stump

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