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What are the initial success and long-term angiographic recurrence rates of transluminal recanalization for total coronary occlusions?
What are the initial success and long-term angiographic recurrence rates of transluminal recanalization for total coronary occlusions?
Transluminal recanalization of chronic total occlusions using bare-wire technique is feasible with a 75% success rate and an acceptable 36% angiographic recurrence rate at 3-6 months.
Supports feasibility of bare-wire recanalization; leaves open need for contemporary randomized comparisons.
The study presented comprises the initial and angiographic long‐term results of a consecutive series of recanaliza‐tion procedures in a single center. Between 1988 and 1992, a total of 400 patients underwent transluminal recanalization for total coronary occlusions. In 82% of successfully attempted patients, the occlusion could be passed by a standard guidewire. The overall initial success rate was 75% (298 of 400). The highest success rates could be achieved in the left circumflex artery (84%) and left anterior descending coronary artery (77%). Complications were uncomplicated myocardial infarction in ten patients (2.5%) and death in two patients (0.5%). Angiographic follow‐up 3–6 months after recanalization could be achieved in 263 (88%) of 298 patients. Significant restenosis (≥ 50% minimum lumen diameter) was found in 57 (22%) of 263, and reocclusion was present in 38 (14%) of 263 patients, resulting in a total recurrence rate of 36%. In conclusion, recanalization can be performed with an initial success rate of 75% using bare‐wire technique under the prerequisite operator experience. If a nearly complete angiographic follow‐up is performed, the overall recurrence rate is 36%, which seems to be very acceptable in comparison with PTC A results for incomplete obstructions published so far . (J Interven Cardiol 1996;9:73–79)
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Herrmann et al. (1996) studied this question.
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