TEMPORARY TRENDS OF SUCCESS RATE AND CARDIAC COMPLICATION RISK IN CHRONIC TOTAL OCCLUSION RECANALIZATION BY THE ANTEGRADE APPROACH

Temporary trends of success rate and cardiac complication risk in chronic total occlusion (CTO) recanalization by the antegrade approach are studied. From 2009 to 2013, the attempt of coronary artery CTO recanalization by the antegrade approach was undertaken for 217 patients. Depending on the success of CTO recanalization, patients were divided into 2 groups: group 1 (n = 158) – successful procedure, group 2 (n = 59) – unsuccessful attempt of CTO recanalization. By the end of the observation period, the number of patients with more difficult clinical profile and a complex CTO morphology increased, but the CTO recanalization success rate frequency also had a positive tendency. Observed tendencies to increase a general success recanalization rate and the success of CTO recanalization by coronary wire were caused by changes in the recanalization strategy which occurred during the time from 2009 to 2013, including the change of the coronary wire principle of choice, character and sequence of its use. 5 The frequency of a cardiac complication rate remained stable throughout the entire period of observation and varied from 11.3 % in 2012 to 36.6 % in 2011. «Major complications» (death, acute myocardial infarction, emergency coronary artery bypass grafting), the development of cardiac tamponade and pericardium drainage cases were not seen in the current study. In the process of operators experience accumulation, an attempt of CTO recanalization was made in more difficult patients; at the same time, the positive tendency to recanalization success was observed, without any noticeable changes in risk of cardiac complications.

chronic total occlusions, coronary arteries, antegrade approach, temporary trends, recanalization success, cardiac complications

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