Long-term clinical results of the treatment with bare metal stents of chronic total occlusions
Fiorilli, R.; De Felice, F.; Parma, A.; Pucci, E.; Menichelli, M.; Nazzaro, M.S.; Violini, R.
Giornale Italiano di Cardiologia 7(1): 50-55
2006
ISSN/ISBN: 1827-6806 PMID: 16528962 Document Number: 602649
Background. Previous studies have shown that successful recanalization by stent implantation of a chronic total coronary occlusion (CTO) is associated with an improved clinical outcome. However, most of these studies have used first-generation stents and dated regimens of antithrombotic therapy. Methods. We retrospectively investigated the short- and long-term clinical results of current techniques of percutaneous revascularization in 126 consecutive patients with CTO who underwent successful implantation of a new-generation bare metal stent and dual antiplatelet therapy. Results. There were neither in-hospital deaths nor subacute stent thrombosis; periprocedural acute myocardial infarction occurred in 6 (2.3%) patients; 25 (20%) late major events were observed during a mean follow-up of 19 +/- 10 months: one sudden death, two myocardial infarctions, and 22 cases of target vessel revascularization. Length of CTO > 24 mm (odds ratio = 1.06, p < 0.0245) and final minimal lumen diameter < or = 2.5 mm (odds ratio = 0.224, p < 0.01) were identified as independent predictors of late events. Conclusions. The results of current practice of stenting of CTO are encouraging. Only angiographic variables are predictive of long-term clinical outcome.