Experience of percutaneous coronary intervention of chronic total occlusion in native coronary arteries

ABSTRACT

To evaluate the procedural outcome and periprocedural complications of PCI in CTO. Observational study. During 2008 at AFIC/ NIHD. This study was carried out on 311 patients with 319 Chronic total occlusion [CTOs] who underwent percutaneous coronary intervention [PCI] in catheterization laboratory at AFIC/ NIHD. Patients with total occlusions less than three months duration were excluded. After informed consent data was gathered on standard proforma and was analyzed using SPSS 13.0. Out of 311 patients, 264 were males and 47 were females, ranging in age from 30 years to 80 years. Technical success was obtained in 78% of patients and procedural success in 76%. Most common location was LAD 48.2% followed by RCA 32.5%, LCx 18.6%, and LMS 0.6%. Technical success in LAD was 48.3%, RCA was 30.6%, LCx was 20.2% and LMS was 0.8% of the total successful PCIs. Among failed procedures inability to cross the lesion with a guidewire and inability to adequately dilate the lesion with balloon were the reasons of failure in 82.6% and 17.4% patients respectively. No patients died, three patients suffered MI, one patient underwent urgent coronary artery bypass surgery [CABG] and two patients underwent repeat PCI. PCI to CTO is a safe procedure in carefully selected patients and should be offered as a revascularization modality