الفهرس 
Clinical and AngiographicOnly 14 pages are availabe for public view
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Abstract
CTOs are the most technically challenging lesion subset that interventional cardiologists might face. Achieving recanalization of these lesions will have the most impact on future percutaneous coronary interventions (PCI) success (Shannon et al., 2008).
The aim of the study aimed to define the pre-interventional parameters for procedural success of CTO angioplasty.
Our study included 30 patients, 29 males and one female with CTO lesions of more than 1 month duration presenting with significant angina (Class III-IV) or recent acceleration of previously chronic stable angina, together with absence of scar collected from Kobry El Kobba Military Hospital in the period from November 2009 to June 2010.
The age of our study population ranged from 40 to 65 years, an antegrade approach was generally tried first. If antegrade trial failed or complications developed like dissection or perforation, retrograde approach as a secondary approach was performed.
There was no significant affection of the different clinical risk factors on the success of coronary CTO angiolplasty.
The angiographic data revealed that Criteria favoring antegrade approach were tapered lesion length, short lesions of less than 15 mm, lesion angle of less than 45 degress, and presence of bridging collaterals at the CTO segment, while Criteria favoring retrograde approach were Lesion with abrupt en, Lesion > 15mm length, lesion angulation >45 degree, no side branch origin at CTO segment, difficult antegrade wiring, healthy donor vessel, tapered non calcified distal cap, continuous collaterals.
Criteria of failure were difficult antegrade & retrograde wiring, unhealthy donor vessel, blunt calcified distal cap, absence of continuous collaterals.
Stiff wires had the greatest chance to cross the CTO lesions, microcatheter or over the wire balloon (OTW) was helpful in order not to miss the place of the crossing wire during different stages of the procedure and to facilitate the process of wire exchange during the procedure.
Rotablator was used to overcome heavily calcified plaques, IVUS was used to study cautiously the relationship of the CTO to major side branch & the effect of calcification on the success of the procedure.
There was significant reduction in LVIDd & LVIDs and highly significant increase in LVEF after successful recanalization of CTO.