047 Coronary angioplasty of the chronic total occlusion. Outcome and study of the Balance Risc and Benefit. A study of 62 cases

Percutaneous coronary intervention (PCI) of the coronary chronic total occlusion (CTO) is widely discussed because of the difficulty and the risks of the procedure and the controversial but very interesting clinical benefit in case of procedure success.ObjectiveTo evaluate the in-hospital and long-term clinical outcome of PCI in the case of CTO and measure the adverse effects and complications.Methods62 cases of PCI for a CTO were consecutively registered from January 2005 to February 2009. In addition to an assessment of the technical characteristics and procedural outcomes, patients were followed for occurrence of major adverse cardiac events (MACE). These patients are distributed in two groups: (A) for the occlusion between 1 and 3 months age and (B) for the occlusion of more than 3 months age.Results68 lesions were treated in these 62 patients (47 male and 15 female) with mean age of 59 years (40-80). 42% of theses patients were diabetics, 48% smoker and 26% with hypertension. 27 patients had an ST elevation acute coronary syndrome (ACS) and 24 a non ST elevation ACS, where 2 had stable angina. Balloon angioplasty was performed in only 4 cases and the stenting in 58 cases with use of 64 stents (average of 1.1 stent / artery and of 1.2 stent / patient), we used drug eluting stent in only 10 case (15.6%). Total procedure success rate, defined by a patent artery (less then 30% residual stenosis) with TIMI 3 flow (grade 3) at the end of the PCI was 83% (57/68). The success was better in the group A 90% (29/32) then the group B 77% (28/36) (P