Differences in the clinical and angiographic characteristics of chronic total occlusion lesions in the three major coronary arteries

Tasuku Hasegawa, Cosmo Godino, Sandeep Basavarajaiah, Kensuke Takagi, Ahmed Rezq, Azeem Latib, Chieffo Alaide, Matteo Montorfano, Mauro Carlino, Antonio Colombo

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Abstract

Objectives: The purpose of this study was to evaluate the differences in the clinical and angiographic characteristics of chronic total occlusion (CTO) lesions among the 3 major coronary arteries (LAD, LCx, and RCA). Background: The success rate of percutaneous coronary intervention (PCI) of CTO lesions is not uniform among the 3 major coronary arteries and this may be influenced by the differences in angiographic and clinical characteristics that may exists between them. Methods: We retrospectively evaluated clinical and angiographic characteristics of patients who underwent PCI of CTO lesions at our 2 centers between 2003 and 2010. Results:We analyzed 708 CTO-PCI procedures between 2003 and 2010. The CTO lesions were located in LAD: 222 (31.4%), LCx: 167 (23.6%), and RCA: 319 (45.0%). Patients with CTO in LAD had lower incidence of previous history of PCI and CABG compared to those with CTO lesions in LCx or RCA. In regard to angiographic findings, LAD lesions tended to have more side branches and blunt occlusion stump. The LCx lesions presented more frequently as a part of multivessel disease. RCA lesions were significantly longer, more severely angulated, and calcified. Good collateral circulations were more often encountered in the RCA. In regard to success rates, RCA showed lower procedural success rates (71.8%) followed by LAD (74.8%) and LCx (79.0%). Conclusions: There were several differences in the clinical and angiographic characteristics of CTO lesions among the 3 major coronary arteries. These differences can explain the discrepancy in procedure success rates. (J Interven Cardiol 2014;27:44-49).

Original languageEnglish
Pages (from-to)44-49
Number of pages6
JournalJournal of Interventional Cardiology
Volume27
Issue number1
DOIs
Publication statusPublished - 2014

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Percutaneous Coronary Intervention
Coronary Vessels
Collateral Circulation
Incidence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

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Differences in the clinical and angiographic characteristics of chronic total occlusion lesions in the three major coronary arteries. / Hasegawa, Tasuku; Godino, Cosmo; Basavarajaiah, Sandeep; Takagi, Kensuke; Rezq, Ahmed; Latib, Azeem; Alaide, Chieffo; Montorfano, Matteo; Carlino, Mauro; Colombo, Antonio.

In: Journal of Interventional Cardiology, Vol. 27, No. 1, 2014, p. 44-49.

Research output: Contribution to journalArticle

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abstract = "Objectives: The purpose of this study was to evaluate the differences in the clinical and angiographic characteristics of chronic total occlusion (CTO) lesions among the 3 major coronary arteries (LAD, LCx, and RCA). Background: The success rate of percutaneous coronary intervention (PCI) of CTO lesions is not uniform among the 3 major coronary arteries and this may be influenced by the differences in angiographic and clinical characteristics that may exists between them. Methods: We retrospectively evaluated clinical and angiographic characteristics of patients who underwent PCI of CTO lesions at our 2 centers between 2003 and 2010. Results:We analyzed 708 CTO-PCI procedures between 2003 and 2010. The CTO lesions were located in LAD: 222 (31.4{\%}), LCx: 167 (23.6{\%}), and RCA: 319 (45.0{\%}). Patients with CTO in LAD had lower incidence of previous history of PCI and CABG compared to those with CTO lesions in LCx or RCA. In regard to angiographic findings, LAD lesions tended to have more side branches and blunt occlusion stump. The LCx lesions presented more frequently as a part of multivessel disease. RCA lesions were significantly longer, more severely angulated, and calcified. Good collateral circulations were more often encountered in the RCA. In regard to success rates, RCA showed lower procedural success rates (71.8{\%}) followed by LAD (74.8{\%}) and LCx (79.0{\%}). Conclusions: There were several differences in the clinical and angiographic characteristics of CTO lesions among the 3 major coronary arteries. These differences can explain the discrepancy in procedure success rates. (J Interven Cardiol 2014;27:44-49).",
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AU - Godino, Cosmo

AU - Basavarajaiah, Sandeep

AU - Takagi, Kensuke

AU - Rezq, Ahmed

AU - Latib, Azeem

AU - Alaide, Chieffo

AU - Montorfano, Matteo

AU - Carlino, Mauro

AU - Colombo, Antonio

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N2 - Objectives: The purpose of this study was to evaluate the differences in the clinical and angiographic characteristics of chronic total occlusion (CTO) lesions among the 3 major coronary arteries (LAD, LCx, and RCA). Background: The success rate of percutaneous coronary intervention (PCI) of CTO lesions is not uniform among the 3 major coronary arteries and this may be influenced by the differences in angiographic and clinical characteristics that may exists between them. Methods: We retrospectively evaluated clinical and angiographic characteristics of patients who underwent PCI of CTO lesions at our 2 centers between 2003 and 2010. Results:We analyzed 708 CTO-PCI procedures between 2003 and 2010. The CTO lesions were located in LAD: 222 (31.4%), LCx: 167 (23.6%), and RCA: 319 (45.0%). Patients with CTO in LAD had lower incidence of previous history of PCI and CABG compared to those with CTO lesions in LCx or RCA. In regard to angiographic findings, LAD lesions tended to have more side branches and blunt occlusion stump. The LCx lesions presented more frequently as a part of multivessel disease. RCA lesions were significantly longer, more severely angulated, and calcified. Good collateral circulations were more often encountered in the RCA. In regard to success rates, RCA showed lower procedural success rates (71.8%) followed by LAD (74.8%) and LCx (79.0%). Conclusions: There were several differences in the clinical and angiographic characteristics of CTO lesions among the 3 major coronary arteries. These differences can explain the discrepancy in procedure success rates. (J Interven Cardiol 2014;27:44-49).

AB - Objectives: The purpose of this study was to evaluate the differences in the clinical and angiographic characteristics of chronic total occlusion (CTO) lesions among the 3 major coronary arteries (LAD, LCx, and RCA). Background: The success rate of percutaneous coronary intervention (PCI) of CTO lesions is not uniform among the 3 major coronary arteries and this may be influenced by the differences in angiographic and clinical characteristics that may exists between them. Methods: We retrospectively evaluated clinical and angiographic characteristics of patients who underwent PCI of CTO lesions at our 2 centers between 2003 and 2010. Results:We analyzed 708 CTO-PCI procedures between 2003 and 2010. The CTO lesions were located in LAD: 222 (31.4%), LCx: 167 (23.6%), and RCA: 319 (45.0%). Patients with CTO in LAD had lower incidence of previous history of PCI and CABG compared to those with CTO lesions in LCx or RCA. In regard to angiographic findings, LAD lesions tended to have more side branches and blunt occlusion stump. The LCx lesions presented more frequently as a part of multivessel disease. RCA lesions were significantly longer, more severely angulated, and calcified. Good collateral circulations were more often encountered in the RCA. In regard to success rates, RCA showed lower procedural success rates (71.8%) followed by LAD (74.8%) and LCx (79.0%). Conclusions: There were several differences in the clinical and angiographic characteristics of CTO lesions among the 3 major coronary arteries. These differences can explain the discrepancy in procedure success rates. (J Interven Cardiol 2014;27:44-49).

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