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Submitted: 26 June 2008
HERDIN Record #: PCHRD062808030630

Immediate results and three-month clinical outcome after percutaneous coronary interventions in chronic total occlusions.

Ronaldo C. Manuel,
James Ho Khe Sui,
Neil T. Gomez,
Alexander D. Ang,
Rowena G. Cacas

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Background ÃÆ'Æ'Æ’ÃÆ'†â€™ÃÆ'Æ'â€Ã...¡ÃÆ'‚¢ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â‚¬Ã...¡ÃÆ'‚¬ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â€Ã...¡Ã‚¬ÃÆ'‚ Chronically occluded lesions are present in 20-40 percent of patients with angiographically documented coronary artery disease. It accounts for at least 10% of the targets of coronary angioplasty, but they also represent the single most important reason not to attempt coronary angioplasty due to technical difficulty to recanalize the vessel. However in recent years, at the Philippine Heart Center, various guidewires and other more complex devices designed for CTO treatment have become available and more percutaneous angioplasty on CTO are being done. Until recently, there is no local data on the overall impact on the procedural and clinical outcomes of these patients. It is therefore the aim of this study to follow up these patients.

Methods ÃÆ'Æ'Æ’ÃÆ'†â€™ÃÆ'Æ'â€Ã...¡ÃÆ'‚¢ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â‚¬Ã...¡ÃÆ'‚¬ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â€Ã...¡Ã‚¬ÃÆ'‚ This is a descriptive and a case control study on twenty two patients who underwent PCI on CTO at the Philippine Heart Center from January to December of 2005.

Results ÃÆ'Æ'Æ’ÃÆ'†â€™ÃÆ'Æ'â€Ã...¡ÃÆ'‚¢ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â‚¬Ã...¡ÃÆ'‚¬ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â€Ã...¡Ã‚¬ÃÆ'‚ There were 22 subjects, with chronic total occlusion who underwent percutaneous coronary intervention in 2005 included in this study. There was successful recanalization in 50 percent of the subjects. Of which, 64 percent (7) were male, 73 percent (8) had family history of coronary artery disease, 27 percent (3) were diabetic, 91 percent (10) were hypertensive, 73 percent (8) were hyperlipidemic, 27 percent (3) were smoker, 45 percent (5) had a history of myocardial infarction and 64 percent (7) had multivessel involvement. Two subjects who initially had technical failure underwent a second PCI within 72 hours, and eventually had successful recanalization. Statistical analysis comparing the baseline characteristics between subjects who had technical success against those who had technical failure showed no significant difference. Fifty four percent (6) of the subjects with procedural success had LAD involvement, 18 percent (2) involved the LCx and 27 percent (3) involved the RCA.

Conclusion ÃÆ'Æ'Æ’ÃÆ'†â€™ÃÆ'Æ'â€Ã...¡ÃÆ'‚¢ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â‚¬Ã...¡ÃÆ'‚¬ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â€Ã...¡Ã‚¬ÃÆ'‚ Three months follow-up of the 22 subjects showed 91 percent angina-free in both CTO success and CTO failure group. There were no occurence of Q-wave nor non-Q-wave myocardial infarction (Ml). Two subjects under the CTO failure group eventually underwent coronary artery bypass grafting (CABG). There was one mortality in each of the two groups. (Author)

Publication Type
Journal
Publication Sub Type
Announcements
Title
Philippine Heart Center Journal
Frequency
Quarterly
Publication Date
July-September 2006
Volume
12
Issue
3
Page(s)
12-15

Objectives

1. To determine the predictors to a procedural success of PCI of chronic total occlusions.
2. To determine their clinical outcomes in-hospital and after 3 months with regards to major adverse cardiac events (MACE).

LocationLocation CodeAvailable FormatAvailability
Philippine Council for Health Research and Development Library Abstract Print Format (Request Document)