PCI TO CHRONIC TOTAL OCCLUSION, LIAQUAT NATIONAL HOSPITAL EXPERINCE

Abstract

BACKGROUND PCI of chronic total occlusion represents 10%- 20% of all angioplasty procedures and poses a management dilemma for the interventional cardiologist. Percutaneous coronary interventions in chronic total occlusions have been associated with lower success rate. We therefore studied percutaneous interventions in chronic total occlusions done during year 2004 at Liaquat National Hospital Karachi. METHODS All patients with chronic total occlusion undergoing percutaneous coronary interventions were included during year 2004. Data was analyzed using SPSS 10. Version. RESULTS 57 patients with chronic total occlusions underwent PCI out of them 31.58% are female and 68.42%are male. There was no periprocedural or in hospital complications. 49.1% patients had multivessel disease. 33.33% left anterior descending artery lesion, 29.82% right coronary lesion, 24.56% circumflex lesion and 12.28% obtuse marginal lesion. Predilation was done in all cases using various size balloons. Various wires were used and in most cases more than one wire were used. Cypher, Taxus and driver stents were used for stenting. 75.4% are successful while 24.6% were unsuccessful. CONCLUSION Revascularization success rate for CTO in our study was 75.4%that was comparable to other data worldwide. The most common reason for procedural failure included the inability to cross the occlusion with guidewire (57.14%), failure to cross the occlusion with a balloon (28.57%) and failure to dilate the stenosis (12.28%).