Abstract 15036: An Assessment of the Presence of Collateralisation as a Predictor of Angiographic Success Rates of Percutaneous Coronary Intervention in Chronic Total Occlusions
Background: Chronic total occlusions (CTO's) represent the most challenging lesions for percutaneous coronary intervention (PCI). Aim: We sought to clarify the importance of contralateral (contra) and homolateral (homo) collaterals as a predictor of angiographic success.
Methods: All patients treated with PCI for CTO's (European CTO club definition) in our institution were prospectively entered in a dedicated database (2004–2009). The presence of contra and homo collaterals were assessed by a senior interventionalist and classified according to the Rentrop criteria. Patients were divided into 2 groups based on the presence of contra collaterals classified as poor (Rentrop grade 0–1) or good (grade 2–3). They were further subdivided into 2 groups according to the presence of poor or good homo collaterals. We additionally looked at the use and role of contra injection according to the collaterals grade.
Results: 960 patients, aged 63.1±11.6 years were studied. Baseline demographics were similar in the 4 groups. As shown in the figure, there was no difference is success rates based on the presence or absence of good contra collaterals (p=0.65). But in patients with good contral collaterals, additional homo collaterals were associated with an increased rate of success (p=0.01). In patients with poor contra collaterals, there was no difference in angiographic success if contra injection was used or not (72.4 vs. 59.5%, p=0.14). Similar results were observed in patients with good contra collaterals (71.8 vs. 66.7%, p=0.17).
Conclusions: Well established contralateral collaterals are not associated with an increase in angiographic success even when a bilateral approach is used. Having good homolateral collaterals appears to be a better predictor of success.
- © 2010 by American Heart Association, Inc.