Interventional strategies and techniques for chronic total occlusion of two major coronary arteries

AIM:To explore the clinical and lesion features and interventional strategies/techniques for chronic total occlusion of two major coronary arteries so as to enhance the success rate of interventional treatment and survival rate of patients with chronic total occlusion of two major coronary arteries. METHODS: From January 2004 to January 2008, 104 patients with chronic total occlusion of two major coronary arteries diagnosed by coronary artery angiography and treated with percutaneous coronary intervention (PCI) treatment were enrolled in this study. Patients were divided into three groups: group A occlusion of the right coronary plus left anterior descending coronary artery (n=33 cases), group B occlusion of the right coronary artery plus left circumflex coronary artery (n=30 cases) and group C occlusion of the left anterior descending coronary artery plus circumflex artery (n=41 cases). Clinical data, PCI results, complications, cardiac function and major adverse cardiac events (MACE) during follow-up were retrospectively analyzed. RESULTS: The success rate of interventional treatment is remarkable (96%) with a low rate of complications of interventional treatment. No deaths occurred during operation, no MACE occurred during postoperative hospitalization and no patients were treated with emergency coronary artery bypass grafting (CABG). Significant improvement in cardiac function was found in each group (group A: 36.40±8.2 vs. 47.38±8.9, P<0.01; group B: 40.76±7.8 vs. 50.86±7.5, P<0.01; group C: 35.89±7.4 vs. 45.47±8.0, P<0.01). Incidence of MACE after 1-year follow-up in group C was higher than in group A or group B (P<0.05), whereas no significant difference was found between group A and group B. CONCLUSION: The success rate of interventional treatment and survival rate of patients with chronic total occlusion of two major coronary arteries were significantly improved. Therefore, PCI treatment improves cardiac function of patients with chronic total occlusion of two major coronary arteries and enhances long-term clinical results.