Opening of chronic coronary artery occlusions with a recanalization catheter

Abstract

Percutaneous transluminal angioplasty for recanalization was attempted for 44 chronic coronary arterial occlusions in 41 patients (two occluded vessels in three patients). In 11 instances the occlusion could be passed with a guide-wire. In the other 33 this was not possible. In 25 of them a 3, 4 or 5 F recanalization catheter, its end tapered to 2 or 3 F, was used. In this way re-opening was possible in 17 cases (68%). The catheter made it possible to splint or stiffen the guidewire to keep it straight, superselectively inject contrast medium, measure the pressure distal to the occlusion, and gradually bougie-like enlarge the resulting subtotal stenosis. A total of 28 of 44 coronary occlusions were re-opened (64%). All these patients were functionally improved. At subsequent angiography (a mean of 3.6 months later) 22 of 25 vessels had remained open, but ten had narrowed and three had become re-occluded.