Negative angiographic markers in percutaneous coronary intervention of chronic total occlusions.

Mohsen Mohandes, Jordi Guarinos, Judit Rodríguez, Gil Bonet, Francisco Fernández, Sergio Rojas, Cristina Moreno, Ramón de Castro, Jordi Mercé, Alfredo Bardají

The purpose of this study is to identify negative angiographic predictive variables and the presence of a side branch close to the occlusion distal cap in the chronic total occlusion percutaneous coronary intervention outcome. Potential negative angiographic variables were retrospectively evaluated in 156 chronic total occlusions undergone a percutaneous coronary intervention. Binary logistic regression with predictive purpose was utilized in order to identify a model of variables which all in all could successfully predict a negative intervention result. Variables independently associated with the procedural failure were multivessel disease (odds ratio=5,12; 95% confident interval, 1,94-13,5; P=0.001), ambiguous stump presence (odds ratio = 5,08; 95% confident interval, 2,22-11,63 P<0.001), occlusion length≥20 mm (odds ratio= 3,7; 95% confident interval, 1,37-9,97 P=0.01) and ostial location (odds ratio = 6,53; 95% confident interval, 1,67-25,63; P=0.007). Side branch at distal cap proximity did not remain in the predictive model. Multivessel disease, ambiguous stump, a length≥20 mm and ostial location of a chronic total occlusion are independent predictive factors of an unfavourable angioplasty result. A side branch at occlusion distal cap did not associate with the procedural failure.