RESUMO
Background: revascularization of chronic total occlusion [CTO] is still a challenge for interventional cardiologist due to the low success rate as well as the high restenosis rate in successful cases
Objective: to study the acute and long term results of attempting revascularizaiion of CTO and to study the effect of various clinical and angiographic variables on these results
Methods: 46 cases undergoing PCI and stenting of CTOs were included, the effect of the various clinical and aniographic variables on the immediate results and on the long term F.U were analyzed
Results: there were 42 males and 4 females, the mean age was 50 years, all had CTO aged more than 3m, CTO was LAD in 63%, LCX in 17% and RCA in20%.Tappered end was fond in 63%, side branch vexing at the stump was found in 23% of cases and the length of the occluded segment had a mean of 31.6 mm [7 SD. The presence of viability in the territory of CTO was documented in 79% of cases. The primary success rate was 85%. The RCA lesions and blunt stump shape, non viable myocardium in the territory of the occluded vessel and side branch vexing at the stump were found to be independent predictors of primary failure, while other variables had non significant effect on the procedure results. 6 month F.U were done clinically for all cases, In failed cases MACE was present in 71% of cases and only 14% in successful cases, Exercise stress test was done to all successful cases, positive in 30%. Angiographic restenosis was found only in 18%. RCA location and non viable myocardium had a significantly higher restenosis rate at F.U
Conclusion: CTO recanalization can be safely achieved with a high success rate and a low restenosis rate in selected patients with viable myocardium and favorable anatomy