Is it feasible to perform coronary chronic total occlusion intervention with conventional angioplasty equipment.

OBJECTIVES: To demonstrate feasibility of coronary chronic total occlusion (CTO) procedures with conventional interventional equipment.

METHODS: Ninety-five subsequent CTO patients were analyzed retrospectively. Patients who met the inclusion criteria were intervented with standard angioplasty catheters, guidewires, and balloon catheters. The procedural success rate of the interventions was discussed according to clinical and demographic characteristics of patients and equipment used for intervention. This study was carried out in Istanbul Medicine Hospital, Istanbul, Turkey between January 2007 and June 2011.

RESULTS: Successful revascularization was achieved in 80% of patients, and all patients were discharged on the day after the procedure without complication. The success rate decreased to 60% in the CTOs of more than one year and approximately 90% in the shorter duration. Stent implantation was carried out in 82.9% of patients with a mean stent length of 42.7±21.4 mm. Occlusion duration was the major predictor of successful procedure on regression analysis (p=0.01).

CONCLUSIONS: Coronary intervention for CTO with conventional equipment is still reasonable in the CTOs of short duration. Duration of coronary CTO over a year should be referred to a reference center where skilled operators and specialized equipment for CTOs are widely available.