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  • Title: [Chronic total coronary occlusion dis-obstruction by balloon angioplasty].
    Author: Melchior JP, Meier B, Finci L, Steffenino G, Noble J, Rutishauser W.
    Journal: Arch Mal Coeur Vaiss; 1987 Feb; 80(2):185-9. PubMed ID: 2953319.
    Abstract:
    Ninety-three consecutive patients with chronic total coronary occlusion underwent an attempted mechanical des-obliteration by percutaneous coronary angioplasty with a balloon catheter. The global results were 55 p. 100 initial successes (residual stenosis less than 50 p. 100). The good prognostic factors were: 1) left coronary artery, especially left circumflex artery occlusion p less than 0.50, and 2) the proximity to the date of occlusion as assessed from the clinical history or by the occurrence of occlusion between the time of diagnostic coronary angiography and angioplasty. In cases of recent occlusion dating less than one month, the success rate was high: 69 p. 100. On the other hand, there were no successes in occlusions of over 6 months standing. The presence of myocardial infarction did not influence the results. There were few complications (7 p. 100) and these did not include any deaths or cases requiring emergency surgery. Exercise stress tests were carried out after the procedure and were negative in 28 out of 32 patients (88 p. 100). Forty-three patients successfully revascularised were followed up for 1 to 48 months (average 9 months) after angioplasty. Thirty-one patients were asymptomatic. Of the 12 symptomatic patients, 7 underwent exercise stress tests (6 positive) and all had control angiography which showed restenosis in 10 cases with 5 occlusions. Percutaneous coronary angioplasty of recent total coronary occlusions gives good initial results without major complications, and the medium term clinical results are satisfactory.
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