Risk factors for complications during recanalization of chronic coronary artery occlusions in patients with coronary artery disease

Abstract

The aim — to analyze the risk factors for periprocedural complications during recanalization of chronic coronary artery (CA) occlusions in patients with coronary artery disease.Materials and methods. The study included 365 patients with chronic of CA occlusions, which, on the basis of X‑ray angiography department of M. M. Amosov National Institute of Cardiovascular Surgery of National Academy of Medical Sciences of Ukraine underwent diagnostic and therapeutic intervention procedures for this pathology. The patients’ age was from 62 to 73 years old (average age — 66.96 ± 1.81 years). Occlusions were localized mainly in the proximal (167 (45.8 %) cases) and middle (198 (54.2 %) CA segments. The duration of occlusion was determined from the time of myocardial infarction in the infarct‑related CA pool. Occlusion duration from 3 to 6 months was recorded in 98 (26.8 %) patients, from 6 to 12 months — in 137 (37.5 %) patients, from 1 to 3 years — in 130 (35.6 %) patients. Chronic occlusion of one CA was detected in 93 (25.5 %) persons, two CA — in 127 (34.79 %) persons, three CA — in 56 (15.3 %) persons. In 89 (24.38 %) patients, multiple atherosclerotic lesions of the coronary bed were diagnosed. Mean number of affected CA in one patient was 2.17 ± 0.34.Results and discussion. Out of 235 patients with the term of occlusion up to 1 year, a good angiographic result was achieved in 87.2 %, out of 130 persons with occlusion duration of 1— 3 years — in 72.3 %. The average number of implanted stents was 2.12 ± 0.3 per one patient. 51 (13.97 %) patients had periprocedural complications. The development of «big» complications of X‑ray endovascular coronary interventions for chronic occlusion of CA was statistically significantly influenced by the patient’s age and smoking (p < 0.05), the probability of developing «small» periprocedural complications — by body mass index and diabetes.Conclusions. Risk factors for the development of «big» complications are femoral access, the duration of the procedure and fluoroscopy, the amount of contrast material used during the procedure.