RESUMO
Background: left main coronary artery [LMCA] disease is a potentially lethal disease that can be effectively treated if it is recognized early. The aim of our study was to define the demography of patients with left main disease among those undergoing angiography at our center
Methods: the profile of 180 patients, who were found to have left main disease out of a total of 1111 consecutive patients undergoing coronary angiography, was studied retrospectively. Obstructive left main disease was defined as >/= 50% diameter stenosis on angiogram. All patients having atheromatous involvement of left main coronary artery from plaques to total occlusion were included
Results: the overall incidence of left main disease was 16.2%, however, if only obtrusive lesion lesions were considered it was 4.5%. Mean age was 58.9 years. 41.6% [75] were smokers and 50% were hypertensive Diabetes is prevalent in the majority of this patient, being 67.2%, but the incidence of obstructive disease is not increased. Obstructive left main disease is seen in 34.7% among male smokers against 21.6% in nonsmokers
Conclusion: left main disease appears to be related to increasing age. Diabetes is the commonest prevalent risk factor in this patient population. Among male smokers obstructive left main disease prevalence is higher than nonsmokers
RESUMO
Background: PCI of chronic total occlusion represents 10%- 20% of all angioplasty procedures and poses a management dilemma for the interventional cardiologist. Percutaneous coronary interventions in chronic total occlusions have been associated with lower success rate. We therefore studied percutaneous interventions in chronic total occlusions done during year 2004 at Liaquat National Hospital Karachi
Methods: All patients with chronic total occlusion undergoing percutaneous coronary interventions were included during year 2004. Data was analyzed using SPSS 10. Version
Results: 57 patients with chronic total occlusions underwent PCI out of them 31.58% are female and 68.42%are male. There was no periprocedural or in hospital complications. 49.1% patients had multivessel disease. 33.33% left anterior descending artery lesion, 29.82% right coronary lesion, 24.56% circumflex lesion and 12.28% obtuse marginal lesion. Predilation was done in all cases using various size balloons. Various wires were used and in most cases more than one wire were used. Cypher, Taxus and driver stents were used for stenting. 75.4% are successful while 24.6% were unsuccessful
Conclusion: Revascularization success rate for CTO in our study was 75.4%that was comparable to other data worldwide. The most common reason for procedural failure included the inability to cross the occlusion with guidewire [57.14%], failure to cross the occlusion with a balloon [28.57%] and failure to dilate the stenosis [12.28%]