The Relative Analysis Of Relationship Between Occlusion Duration Of CTO And Success Rate Of Antegrade Wire Technique

Objectives:The aim of this study was to identify the impact of occlusion duration(OD)on angiographic success in patients underwent chronic tota l occlusion(CTO).Methods:A total of 1088 cases of CTO patients were collected for interventional treatment of the General Hospital of Shenyang Military Region from January 2013 to December 2014,including 21 CTO patients who taken direct retrograde wire technique,170 CTO patients taken antegrade wire technique combined with retrograde wire technique,897 CTO patients selected antegrade wire technique for percutaneous coronary intervention(PCI).This study retrospectively analyzed the patients who used antegrade wire technique opened CTO lesions.To analyzed the clinical features(gende?age?hypertension?diabetes?smoking?drinking or stroke)?occlusion duration?the features of imaging(calcification?collateral etc.)and the results of interventional treatment.The routes of intervention treatment including :the right radial artery?the left radial artery?the right femoral artery and the left femoral artery.According to the difficulty of surgery and surgical strategies chosen one or two approaches.There are two ways:(1)antegrade pathway combined with the same side contrast;(2)the antegrade pathway combined with the counter side contrast.Selected antegrade pathway combined with the same side contrast in the patients who qualified collateral and short occlusion?less difficulty of PCI;otherwise,chosen the antegrade pathway combined with the counter side contrast.According to the characteristics of the target lesions selected the guiding catheter with strong support,such as EBU,XB,AL,SAL,JR,JL guiding etc.To analyzed the clinical features(gende?age?hypertension?diabetes?smoking?drinking or stroke)?occlusion duration?the features of imaging(calcification?collateral etc.)and the results of interventional treatment.Results:The median time of occlusion duration was 24 months in CTO lesions(IQR,4-72months).The total successful ratio was 83.6%(750/897).Logistic stepwise regression analysis showed that the relationship between occlusion duration and the success of CTO lesions was negative correlation(OR:0.997,P=0.021).The further analysis of subgroup showed: predictive factors on successful PCI were absence of male(P=0.019)? uneders(age< 65years)(P=0.037)?smokers(P=0.021)?hypertension(P=0.008)?diabetes(P=0.015)or the target lesion was the right coronary artery(P=0.008).Conclusion: The relationship between occlusion duration and the success of CTO lesions was negative correlation,and with the extension of occlusion duration the successful ratio of intevention was lower from month to month.Especially the patients were absence of male?uneders(age<65years)?smokers?hypertension ?diabetes or the target lesion was the right coronary artery.