eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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vol. 14
Original paper

Does the effectiveness of recanalization of chronic occlusion depend on the location of the obstruction?

Leszek Bryniarski, Łukasz Klima, Sławomir Surowiec, Krzysztof L. Bryniarski, Michał Terlecki, Dariusz Dudek

Adv Interv Cardiol 2018; 14, 3 (53): 258–262
Online publish date: 2018/09/21
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In past studies, it has been questioned whether success of recanalization of chronic total occlusion (CTO) depends on the location of the occlusion – the circumflex artery (Cx) was considered as the most difficult to open.

To determine whether the effectiveness of recanalization of CTO depends on the location of the obstruction.

Material and methods
From January 2011 to January 2016, a single operator dedicated to chronic total occlusions performed in our center 357 procedures on 337 patients.

Among 337 patients included in the study, 83.4% were male. Mean age was 62.8 ±9.3 years. Most of the patients had hypertension (86.4%) and hyperlipidemia (99.4%), and 28.8% of them had diabetes. The most frequently opened artery was the right coronary artery (RCA; 52.4%), followed by the left anterior descending artery (LAD; 29.4%), and last the Cx (18.2%). The mean J-CTO score was comparable between the three groups. The success rate of recanalization of CTO was similar for all arteries: 84.5% in the RCA, 81.9% in the LAD and 89.2% in the Cx (overall p = 0.437). Neither procedural complications nor adverse events depended on the location of the CTO.

Our study shows the same efficacy of CTO procedures of all epicardial arteries. We did not observe that effectiveness of recanalization of CTO depends on the location of the obstruction.


chronic total occlusion, percutaneous coronary intervention, lesion characteristics

Bryniarski L, Bryniarski KL. Which parameters are important before attempting chronic total occlusions recanalization? Adv Interv Cardiol 2016; 12: 96-8.
Christopoulos G, Karmpaliotis D, Wyman MR, et al. Percutaneous intervention of circumflex chronic total occlusions is associated with worse procedural outcomes: insights from a Multicentre US Registry. Can J Cardiol 2014; 30: 1588-94.
Sianos G, Werner GS, Galassi AR, et al. Recanalisation of chronic total coronary occlusions: 2012 consensus document from the EuroCTO club. EuroIntervention 2012; 8: 139-45.
Di Mario C, Werner GS, Sianos G, et al. European perspective in the recanalisation of chronic total occlusions (CTO): consensus document from the EuroCTO Club. EuroIntervention 2007; 3: 30-43.
Gülker JE, Bansemir L, Klues HG, Bufe A. Chronic total coronary occlusion recanalization: current techniques and new devices. J Saudi Heart Assoc 2017; 29: 110-5.
Muramatsu T, Tsukahara R, Ito Y, et al. Changing strategies of the retrograde approach for chronic total occlusion during the past 7 years. Catheter Cardiovasc Interv 2013; 81: E178-85.
Dębski M, Dębski A, Tyczyński P, et al. Retrograde recanalization of chronic total occlusion. A novel maneuver of the old technique. Adv Interv Cardiol 2017; 13: 82-3.
Karmpaliotis D, Green P. Chronic Total Occlusion Percutaneous Coronary Intervention in 2014 Beyond the J-CTO Score (Japanese Multicenter CTO Registry): chance favors the prepared mind. JACC Cardiovasc Interv 2015; 8: 268-70.
Michael TT, Karmpaliotis D, Brilakis ES, et al. Procedural outcomes of revascularization of chronic total occlusion of native coronary arteries (from a multicenter United States registry). Am J Cardiol 2013; 112: 488-92.
Rathore S, Matsuo H, Terashima M, et al. Procedural and in-hospital outcomes after percutaneous coronary intervention for chronic total occlusions of coronary arteries 2002 to 2008: impact of novel guidewire techniques. JACC Cardiovasc Interv 2009; 2: 489-97.
Galassi AR, Tomasello SD, Reifart N, et al. In-hospital outcomes of percutaneous coronary intervention in patients with chronic total occlusion: insights from the ERCTO (European Registry of Chronic Total Occlusion) registry. Eurointervention 2011; 7: 472-9.
Morino Y, Kimura T, Hayashi Y, et al. In-hospital outcomes of contemporary percutaneous coronary intervention in patients with chronic total occlusion: insights from the J-CTO Registry (Multicenter CTO Registry in Japan). JACC Cardiovasc Interv 2010; 3: 143-51.
Baykan AO, Gür M, Acele A, et al. Predictors of successful percutaneous coronary intervention in chronic total coronary occlusions. Adv Interv Cardiol 2016; 12: 17-24.
Bryniarski L, Surowiec S, Klima Ł, et al. Recanalisation of coronary chronic total occlusion by retrograde approach: the first experience in Poland. Kardiol Pol 2015; 73: 167-76.
Christopoulos G, Kandzari DE, Yeh RW, et al. Development and validation of a novel scoring system for predicting technical success of chronic total occlusion percutaneous coronary interventions: the PROGRESS CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) Score. JACC Cardiovasc Interv 2016; 9: 1-9.
Joyal D, Afilalo J, Rinfret S. Effectiveness of recanalization of chronic total occlusions: a systematic review and meta-analysis. Am Heart J 2010; 160: 179-87.
Elias J, Hoebers LPC, Dongen IM, et al. Impact of collateral circulation on survival in ST-segment elevation myocardial infarction patients undergoing primary percutaneous coronary intervention with a concomitant chronic total occlusion. JACC Cardiovasc Interv 2017; 10: 906-14.
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