Abstract 3525: Improvement in Survival Following Successful Angioplasty of Coronary Chronic Total Occlusions: Variability by Target Vessel
Background: Previous analyses have shown improved long-term survival following successful angioplasty for chronic total occlusion (CTO) of coronary arteries. We analyzed the long term survival benefit of selectively opening a CTO of the Left Anterior Descending (LAD), Left Cricumflex (LCx) or Right Coronary Artery (RCA).
Methods: Patients were identified from a 25 year procedural database. They were eligible if they underwent attempted PCI of a CTO in a single vessel during the study period. Procedural success rates, defined as successful dilatation of the target lesion with <40% residual stenosis, were calculated for each vessel.
Results: There were 1,925 patients eligible for this analysis. The LAD was the target vessel in 702, the LCx in 534, and the RCA in 689. Procedural success rates were 73% for the LAD, 70% for the LCx, and 68% for the RCA. Baseline characteristics and comorbidities were well matched, including age, hypertension, high cholesterol, diabetes, and prior PCI. Gender differed across groups (LAD - 79% male, LCx - 83%, RCA - 74%, p<0.001). Procedural success was associated with improved five-year survival in the LAD (success 88.9% vs. failure 73.8 %, p<0.0001) and RCA groups (success 86.5% vs. failure 81.7%, p=0.001), but not in the LCx group (success 86.1% vs. failure 81.3%, p=0.28).
Conclusions: Successful PCI of CTO is associated with improved long-term survival in the LAD and RCA, but not the LCx.