Procedural, In-Hospital and One Year Follow-Up Outcome of Success versus Failure Percutaneous Coronary Intervention in Chronic Total Occlusions

Introduction Percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) lesions are the most technically challenging for the interventional cardiologist with lower procedural success rates and higher complications. However, there are controversy in short-term and long-term results. Aims and Objectives The purpose of this study was to know the procedural success rate, in-hospital and 1 year follow-up outcome of successful versus failure PCI in CTO. Material And Methods This single center, observational study was conducted at KLEs Dr Prabhakar Kore Hospital & MRC, Belgaum, Karnataka, India, from January 2013 to September 2014. A total of 101 consecutive CTO patients in whom PCI was attempted were included in the study. Detailed clinical, angiographic, procedural, in-hospital and 1 year follow-up outcome data were collected and compared success versus failed procedures. Results Procedural success rate was seen in 79 patients (78.21 %). Patients with failed CTO-PCI compared to success group had a higher incidence of diabetes mellitus (72.73 % vs.54.43 %, p=0.14), smoking (54.55 % vs.41.77 %, p=0.33), prior myocardial infarction (MI) (68.18 % vs.41.77 %, p=0.03) and multivessel involvement (13.6 % vs.8.86 %, p=0.53). In-hospital major adverse cardiac events (MACE) rate was significantly higher in failed CTO-PCI (31.82 % vs.0 %, p=0.00) patients. When followed-up for 1 year, failed CTO-PCI was significantly associated with higher rate of 1 year MACE (57.14 % vs.18.99 %, p=0.00), especially revascularization (33.33 % vs.12.66 %, p=0.04). Conclusion A successful PCI of CTOs was associated with better one year follow-up outcome with lower incidence of death, MI and need of CABG compared to failed CTO-PCI