Chronic total occlusion percutaneous coronary intervention: Short and medium term results

Introduction Coronary chronic total occlusion (CTO) angioplasties are considered the most complex of angioplasties requiring experienced operators as well as many specific materials and techniques. Purpose This study aims to identify the predictors of success or failure of CTO angioplasty and to evaluate the short- and medium-term results of this procedure. Material and methods This study is a single-centric retrospective comparative study including patients who underwent CTO angioplasty in the cardiology “A” department at Fattouma-Bourguiba Hospital during the period between January and 2008 and December 2015. Results Our study included 200 patients with attempt of CTO angioplasty. The mean age was 63 ± 8.63 years and the mean number of cardio-vascular risk factors was 2.67. Acute coronary syndrome was the main indication (57.5%) for coronarography. A multi-truncal coronary status was reported in 53.5% of the cases. The mean J-CTO score was 1.42 ± 1.3 and 44% of lesions were estimated difficult to very difficult. The anterograde approach has been the most used technique. The angiographic success of ATL has been reported in 106 patients (53%). DES were implanted in 69.9% of cases. The leading cause of angioplasty failure was the impossibility to cross the lesion by the wire. The procedural complications occurred in 11.5% of cases. The independent predictors of ATL failure were: dyslipidaemia, a bending > 45 degrees (P  Conclusion The results of our study showed a clinical benefit of CTO angioplasty in case of success and demonstrated once more many failure predicting angiographic factors.