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ȣ - 520812 30 |
Impact of Target Lesion Location on the Mid-term Angiographic and Clinical Outcomes of Chronic Total Coronary Occlusion Intervention |
고려대학교 구로병원 순환기내과 |
나승운, , Kang-Yin Chen, Zhe Jin, Yoshiyasu Minami, Yong-Jian Li, Kanhaiya L. Poddar, 박재형, 나진오, 최철웅, 임홍의, 김진원, 김응주, 박창규, 서홍석, 오동주 |
Background: Chronic total occlusion (CTO) intervention is still challenging because of the limited procedural success rate and higher target lesion failure. So far, it is not clear whether the target lesion location will have an impact on the outcomes of the CTO intervention in the drug-eluting stent (DES) era.
Method: A total of 132 patients (pts) underwent CTO intervention in Korea University Guro Hospital from December 2004 to December 2007. Among them, 124 patients (93.9%) achieved target lesion recanalization, and they were divided into left anterior descending artery group (LAD group, n=50 pts), left circumflex artery group (LCX group, n=25) and right coronary artery group (RCA group, n=49 pts) according to the target CTO lesions. Angiographic and clinical outcomes at 6 months were evaluated.
Result: The overall failure rate were similar among the 3 groups (LAD 3 pts, LCX 2 pts, and RCA 2 pts; P=0.360). Baseline characteristics were similar among these 3 groups. At 6 months, these 3 groups showed similar angiographic and clinical outcomes. RCA group had 2 cases of late stent thrombosis whereas LAD and LCX group had no stent thrombosis, but this was not statistically significant (Table).
Conclusion: In the present study, the target lesion location did not exert a significant impact on the immediate procedural success and mid-term angiographic and clinical outcomes in pts with successful CTO intervention with DES.
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Table: Angiographic and clinical outcomes at 6 months
Variables, n (%) |
LAD
(n= 50 pts) |
LCX
(n= 25 pts) |
RCA
(n= 49 pts) |
P value |
Binary restenosis |
5 (10.0) |
2 (8.0) |
6 (12.2) |
0.844 |
Late loss, mm |
0.64 ± 0.54 |
0.71 ± 0.61 |
0.75 ± 0.59 |
0.242 |
Total death |
1 (2.0) |
0 (0) |
0 (0) |
0.474 |
Q-wave MI |
0 (0) |
1 (4.0) |
1 (2.0) |
0.412 |
TLR |
3 (6.0) |
3 (12.0) |
4 (8.2) |
0.667 |
TVR |
3 (6.0) |
3 (12.0) |
4 (8.2) |
0.667 |
TVR-MACE |
4 (8.0) |
4 (16.0) |
5 (10.2) |
0.565 |
Stent thrombosis |
0 (0) |
0 (0) |
2 (4.1) |
0.211 |
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