Does the effectiveness of recanalization of chronic occlusion depend on the location of the obstruction?

Postepy Kardiol Interwencyjnej. 2018;14(3):258-262. doi: 10.5114/aic.2018.78328. Epub 2018 Sep 21.

Abstract

Introduction: In past studies, it has been questioned whether success of recanalization of chronic total occlusion (CTO) depends on the location of the occlusion - the circumflex artery (Cx) was considered as the most difficult to open.

Aim: To determine whether the effectiveness of recanalization of CTO depends on the location of the obstruction.

Material and methods: From January 2011 to January 2016, a single operator dedicated to chronic total occlusions performed in our center 357 procedures on 337 patients.

Results: Among 337 patients included in the study, 83.4% were male. Mean age was 62.8 ±9.3 years. Most of the patients had hypertension (86.4%) and hyperlipidemia (99.4%), and 28.8% of them had diabetes. The most frequently opened artery was the right coronary artery (RCA; 52.4%), followed by the left anterior descending artery (LAD; 29.4%), and last the Cx (18.2%). The mean J-CTO score was comparable between the three groups. The success rate of recanalization of CTO was similar for all arteries: 84.5% in the RCA, 81.9% in the LAD and 89.2% in the Cx (overall p = 0.437). Neither procedural complications nor adverse events depended on the location of the CTO.

Conclusions: Our study shows the same efficacy of CTO procedures of all epicardial arteries. We did not observe that effectiveness of recanalization of CTO depends on the location of the obstruction.

Keywords: chronic total occlusion; lesion characteristics; percutaneous coronary intervention.