Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
Chronic total occlusions (CTOs) are considered as the most complex lesions to treat via percutaneous coronary intervention (PCI), due to the indications, costs and technical difficulties related to these procedures. As a consequence, only about 10% of all coronary artery diseased patients (CAD), clinically eligible for revascularization, are currently being treated via percutaneous coronary intervention (PCI). The majority is treated either medically or by coronary artery bypass graft (CABG) surgery.
OBJECTIVE:
This study sought to estimate the value of application of J- CTO score as a model to stratify the complexity and predict success rates at Iraqi Center for Heart Disease.
METHODS:
One hundred patients with chronic total occlusion were enrolled in this study form October 2014 - May 2015 who were attending Iraqi Center for Heart Disease. Data were collected on demographic, clinical and angiographic characteristics and reviewed by experienced Chronic total occlusions(CTO) operators. Descriptive analyses were performed using Statistical Package of Social Sciences (SPSS) to assess the relationship between procedural success and any variable of the demographic, angiographic and/or clinical characteristics. The level of significance was set at 95% or higher.
RESULTS:
Sixty-one patients out of 100 patients (61%) had a successful PCI. Univariate analyses showed significant differences of Electrocardiography and number of diseased arteries with J-CTO score between the group with successful PCI compared with those with failed PCI.
Angiographically, using Japanese chronic occlusion score we found that a “blunt stump” (42 vs. 75%, p=0.001), “calcifications” (37 vs.70%, p=0.003), “tortuosity” (21 vs. 67%, p=0.001), “CTO length” (44 vs. 84%, p=0.000) and a “re-attempt” (33 vs. 65%, p=0.036) all had a significant negative impact on procedural outcome.
CONCLUSION:
The J-CTO score is valuable tool for predicting successful revascularization of chronic total occlusion by Percutaneous coronary intervention (PCI).