IMMEDIATE OUTCOME OF CORONARY ANGIOPLASTY IN CHRONIC TOTAL OCCLUSIONS WITH BRIDGING COLLATERAL VESSELS

Authors

Department of Cardiology, Imam Khomeini Medical Center, Tehran University of Medical Sciences, Tehran, Iran

Abstract

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).

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