Author + information
- Ali Reza Serati1,
- Mohammad Hasan Namazi2,
- Hosein Vakili1,
- Morteza Safi Morteza Safi1,
- Saeed Ali Pour parsa1,
- Habibollah Saadat1,
- Maryam Taherkhani2,
- Sepideh Emami1,
- Shamseddin Pedari1,
- Masoomeh Vatanparast1 and
- Mohammad Reza Movahed Sr.3
- 1Cardiovascular research center, Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
- 2Cardiovascular research center, Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
- 3The Southern Arizona VA Health Care System and University of Arizona Sarver Heart Center, Tucson, AZ
Total occlusion of a coronary artery for more than 3 months is defined as chronic total occlusion (CTO). The goal of this study was to develop a risk score in predicting failure or success during attempted percutaneous coronary intervention (PCI) of CTO lesions using anterograde approach.
This study was based on retrospective analyses of clinical and angiographic characteristics of CTO lesions that were assessed between February of 2012 and February of 2014. Success rate was defined as passing through occlusion with successful stent deployment using an anterograde approach.
188 patients were studied. Mean±SD age was 59±9 years. Failure rate was 33%. In a stepwise multivariate regression analysis, bridging collaterals (OR=6.7, CI=1.97-23.17, Score=2), absence of stump (OR=5.8, CI=1.95-17.9, score=2), presence of calcification (OR=3.21, CI=1.46-7.07, score=1), presence of bending (OR=2.8, CI=1.28-6.10, score=1), presence of near side branch (OR=2.7, CI=1.08-6.57, score =1) and absence of retrograde filling (OR=2.5, CI=1.03-6.17, score =1) were independent predictors of PCI failure. A score of 7 or more was associated with 100% failure rate whereas a score of 2 or less was associated with over 80% success rate.
Most factors associated with failure of CTO PCI are related to lesion characteristics. A new risk score (range 0-8) is developed to predict CTO-PCI success or failure rate during anterograde approach as a guide before attempting PCI of CTO lesions.