Differences in interventional techniques for patients with complete coronary artery occlusion at different durations of disease

Abstract

Objective To discuss difference in interventional techniques for patients with different degrees of coronary artery total occlusion. Methods Fifty patients with complete coronary artery occlusion who were treated by interventional therapy in Meizhou Hospital of Traditional Chinese Medicine from January 2017 to June 2018 were selected. And they were divided into Non-CTO group (n=38)and CTO group (n=18) according to the course of disease. Their angiographic features of coronary artery leison, techniques and apparatus applied during treatment procedure were retrospectively analyzed. Results There was no significant difference in the number of vessels between the two groups (P>0.05). In terms of vascular lesions, the incidence of left anterior descending coronary artery lesions in Non-CTO group was higher than that in CTO group (P<0.05), while the incidence of left circumflex artery lesion and right coronary artery lesion in CTO group was higher than that in Non-CTO group (P<0.05). The success rate of operation in Non-CTO group was 28/32, while it was 13/18 in CTO group, and the difference was significant (P<0.05). Most patients in Non-CTO group underwent surgery via radial artery approach (P<0.05), while most patients in CTO group underwent surgery via femoral artery approach (P<0.05). The number of guide wire, ratio of patients using micro catheter and bilateral angiography in CTO group were more than those in Non-CTO group (P<0.05). In CTO group, two patients had to undergo reverse technology to complete the operation. Conclusions The intervention treatment for CTO patients requires high-level technology and low success rate; and it should be accomplished by other techniques, such as using femoral artery approach to provide strong support for interventional therapy, using different wires to improve the throughput rate of coronary artery occlusion lesions, and use of micro catheter, bilateral angiography and retrograde wire technique, so as to improve the success rate of interventional operation. Key words: Coronary disease; Occlusion; Percutaneous coronary intervention