Department of Cardiology, Imam Khomeini Medical Center, Tehran University of Medical Sciences, Tehran, Iran
Background- In angioplasty of chronic total occlusion, categorizing lesion characteristics may be useful for their impact on procedural success. There is controversy about the role of bridging collateral vessels in chronic total occlusion procedural outcomes. This study investigated the effect of bridging collateral vessels on the success of coronary angioplasty in patients with chronic total occlusions. Methods- Seventy-seven consecutive patients undergoing coronary angioplasty for chronic total occlusion were classified into two groups. Group I patients had chronic total occlusion with bridging collateral vessels (27 patients), and patients in group II had no such vessels (50 patients). Results- Procedural success was achieved in 11 patients in group I and in 41 patients in Group II (40.7% vs. 82%; p=0.0002; relative risk 3.9; 95% confidence interval 1.7 - 6.4). Of 52 patients with successful angioplasty, patients with an estimated duration of occlusion of less than 3 months had more successful results than patients with occlusions of over 3 months (63.5% vs. 47.5%; p=0.0001; relative risk 1.8; 95% confidence interval 1.3-2.6). The presence of a side branch 2mm or less from the occlusion point was a predictor of an unsuccessful result (p=0.0007; relative risk 2.9; 95% confidence interval 1.5-5.6). Conclusion- There are some morphologic variables which may be useful in guiding angioplasty in patients with chronic total coronary occlusion. Presence of bridging collateral vessels is one of them, which appears to be inversely related to procedural success (Iranian Heart Journal 2003; 4 (4):16-21).