PROCEDURAL OUTCOMES OF CHRONIC TOTAL OCCLUSIN-PERCUTANEOUS CORONARY INTERVENTION, AN UPDATED ANALYSIS OF AFIC/NIHD CTO-PCI REGISTRY

Abstract

Objective: To evaluate the procedural outcomes of patients having chronic total occlusion undergoing percutaneous coronary intervention at our clinical setup.

Study Design: Descriptive cross sectional study.

Place and Duration of Study: This study was conducted at Armed Forces Institute of Cardiology & National Institute of Heart Diseases, Rawalpindi from Jul 2014 to Jun 2017.

Material and Methods: A total of 536 patients who underwent for percutaneous coronary intervention- chronic total occlusion were included in our study. Patients with chronic total occlusion lesion ≥3 months were included in our study. All the patients underwent percutaneous coronary intervention of chronic total occlusion Vessel were selected by non probability sampling technique. Patient’s clinical, demographic data and data regarding procedural outcome was recorded. Finally data was analyzed using descriptive statistics.

Results: Out of 536 patients 468 (87%) were male while 68 (12%) were female. Mean age was 55.5 ± 11.6 Years from 36 to 81 Years. Two hundred and one (37.5%) patients were diabetic, 181(33.7%) were hypertensive and 224 (41.7%) were smokers. Mean LVEF% was 48.7 ± 7.1 (Mean ± SD). Most common vessel involved was RCA 248 (46.2%) followed by LAD 188 (35.0%). Only drug eluting stents (DES) were implanted in successful cases with average no of stents used per patient were 1.43 ± 0.7. Common reasons for failure of procedure was inability of balloon/microcatheter to cross the lesion, inability to cross through retrograde collaterals but the most common reason was the failure of wire to cross the CTO lesion. The overall procedural success was achieved in 73.1% patients. No deaths were reported during the procedures.

Conclusion: The recanalization of CTO lesion was successfully done in 73% cases using PCI. Most common reason for unsuccessful revascularization was failure of guide wire to cross the lesion. With increasing experience and better equipment recanalization of CTO coronary lesions is a safe and effective treatment option for patients with persistent Angina even on optimal medical treatment.