Abstract 18181: Predictors of Success for Percutaneous Coronary Intervention of Chronic Total Occlusions: a Consecutive Series of 1,500 Patients
Introduction & Hypothesis. Percutaneous Coronary Intervention (PCI) of chronic total occlusions (CTOs) remains challenging in terms of indication and technique. Newer techniques continue to develop that may improve safety and the rate of success. We aim to examine factors that may predict success in order to improve patient selection and acute results.
Methods & Results. Of 1,508 consecutive PCIs of CTO in our institution performed between January 2004 and January 2012, the success rate was 71%. Operator experience was defined as the number of cases performed. Patients were 63.5±11.3 years old, 86% male, creatinine 98±65 μmol/L, previous CABG 8%, previous MI 23%, previous PCI 39%, lesion length 20±17 mm. Definite CTO age was known only in 17.9% of cases and the mean CTO age was 26±46 months. Radial approach was used in 82% of cases, procedural duration was 92±50 min and amount of contrast media was 280±171 ml. In hospital outcome was as follows: access site complication 0.4%, hemoglobin drop >5 g/dL 0.07%, peri-procedural MI 0.33%, emergency CABG 0.27%, pericardiocentesis 0.81% and death 0.99%. The table summarizes the predictors of success by univariate and multivariate analyses.
Conclusions. In this contemporary series, the traditional factors of lesion length, calcification, stump visibility and proximal tortuosity remain highly robust predictors, as well as other anatomical and clinical factors such as previous MI and previous CABG. The presence of intraluminal channel and operator’s experience also significantly contribute to success. Table 1
- © 2012 by American Heart Association, Inc.