Background- Angioplasty for chronic total coronary occlusion has remained a technical challenge for the interventional cardiologist, and restenosis rates remained unacceptably high. Recent trials have show that stent placement significantly redu us the rate of restenosis. We evaluated the procedural success and the immediate and long-term clinical outcome of percutaneous transluminal coronary angioplasty (PTCA) for chronic total coronary occlusion (CTO).
Methods and Results- Between November 1998 and October 2000, 147 consecutive patients were submitted to PTCA for CTO. The mean duration of total occlusion was 3.9 + 1.4 months. The angiographic success rate was achieved in 92% of patients. There were no deaths and no emergency CABG.
Stenting was performed in 69 patients (50.7%), with stent-like results in the remaining patients (49.3%). The mean duration of clinical follow up was 25 months. The restenosis rate was 44.7% in the PTCA group versus 26% in the stent group (p< 0.01). During the follow-up, target lesion revascularization was performed in 25.4% of PTCA group vs. 11.6% of stent group.
Conclusions- We conclude that percutaneous transluminal coronary angioplasty for chronic total coronary occlusion is a safe procedure with a high success rate. Stent implantation after balloon angioplasty of chronic total coronary occlusion improved long-term outcome and is therefore recommended even after PTCA with stent-like results