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Safety of coronary angioplasty to chronic total occlusions

Jens G Kilian1, David S Celermajer, Mark R Adams

  • 1Department of Cardiology, Royal Prince Alfred Hospital, Missenden Rd, Camperdown NSW 2050, Australia.

International Journal of Cardiology
|August 16, 2005
PubMed

Insights

Percutaneous transluminal coronary angioplasty (PTCA) for chronic total occlusions (CTO) is feasible and safe. This study shows a success rate of 79% for CTO with a low risk of myocardial necrosis, suggesting it can be performed routinely.

Area of Science:

  • Cardiology
  • Interventional Cardiology

Background:

  • Percutaneous transluminal coronary angioplasty (PTCA) for chronic total occlusions (CTO) is often avoided due to perceived low success rates and high complication risks.
  • Limited data exists on the safety and efficacy of PTCA in CTO cases.

Purpose of the Study:

  • To evaluate the safety and success rate of PTCA for CTO.
  • To compare outcomes of PTCA in CTO patients versus matched controls.

Main Methods:

  • Retrospective analysis of 100 consecutive PTCA cases for CTO.
  • Comparison with 100 matched control patients who underwent PTCA for non-CTO lesions.
  • Assessment of procedural success rates and short-term complications, including cardiac enzyme elevation.

Main Results:

  • Procedural success rate for CTO was 79%, compared to 98% for controls (p<0.001).
  • Cardiac enzyme rise occurred in 5% of CTO patients versus 13% of controls (p<0.05).
  • Significant enzyme rise (myocardial necrosis) was observed in 0% of CTO patients versus 6% of controls (p=0.03).

Conclusions:

  • PTCA for CTO can be performed successfully in most patients.
  • The procedure carries a relatively small risk of myocardial necrosis.
  • These findings support the consideration of PTCA for CTO in selected patients.

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