Key result
The initial success rate of percutaneous transluminal coronary angioplasty in native coronary arteries was significantly lower for chronic total occlusions compared to non-total occlusions (62% vs 98%, p<0.01).
Why the study?
The therapeutic strategy of percutaneous transluminal coronary angioplasty in patients with recurrent angina after coronary artery bypass grafting with saphenous vein graft failure was evaluated due to limited data on outcomes.
Cohort (n=88)
PTCA is a highly successful revascularization strategy for saphenous vein graft failure, though procedural success is significantly reduced in the presence of chronic total occlusions.
The purpose of this study was to evaluate a therapeutic strategy of percutaneous transluminal coronary angioplasty (PTCA) in patients with recurrent angina following coronary artery bypass grafting. The study looked at 112 branches associated with graft failure, excluding new lesions in the native coronary artery (NCA). Chronic total occlusion (CTO) was observed in 50% of NCA (56/112) and in 68% of the grafts (76/112). Thirty-three branches (29%) showed CTO in both NCA and the graft. The overall success rate was 86% (96/112). The success rate on NCA was 98% (44/45) in non-CTO, while in CTO it was significantly lower at 62% (18/29). As to grafts, the success rate was 94% (32/34) in non-CTO, while it was 50% (2/4) in CTO. These characteristics, with respect to lesion morphology and the prevalence of CTO, exerted an influence on the selection of the access vessels for revascularization. Early outcome depended on the result of treatment of CTO.
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Yasuda et al. (1998) conducted a cohort in Angina pectoris following coronary artery bypass grafting (n=88). Chronic total occlusion (CTO) vs. Non-chronic total occlusion (non-CTO) was evaluated on Initial success rate of PTCA in native coronary artery (p=<0.01). The initial success rate of percutaneous transluminal coronary angioplasty in native coronary arteries was significantly lower for chronic total occlusions compared to non-total occlusions (62% vs 98%, p<0.01).
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