Follow-up And Analysis Of Clinical, Angiographic Features In Patients With Coronary Artery Chronic Total Occlusion After Percutaeous Coronary Intervention

Objective:The aim of our study was to investigate the clinical and angiographic follow-up feactures and influential factors of percutanenous coronary intervention (PCI) outcome for chronic total occlusion (CTO)Methods:Retrospectively analyzed the clinical and angiographic data from 120 (101 male,19 female, mean age 60.76±10.71yrs)patients with CTO who were treated with drug-eluting stent (DES) and came back to hospital for Coronary Angiography(CAG) between January 2004 and December 2009. The CTO lesion was calculated by the Quantitative coronary angiography (QCA) software. The differences in categorical variables were analyzedusing a chi-square analysis, and the differences in continuous variables were analyzed by the two-tailed unpaired t-test and liner regression analysis. Their relationship were determined by logistic or liner stepwise regression analysis, and predict factors on effect of PCI for CTO were sieved.Results:The average follow-up time was 13.34±11.79m. Symptom improvement wers achieved in 80 patients (66.7%,80/120).The follow-up echocardiography were available in 70 patients, The average based and follow-up Left ventricular ejection fraction (LVEF) was 63.73±9.15% and 65.21±7.0%.The in stent restenosis(ISR)rate was 18.6%(24/129), including 11 cases of restenosis occlusion (11/129,8.5%). The late stent malapposition (LSM) rate ws 16.3% (21/129), including 14 cases of ectasia (14/129,10.9%) and 2 cases of Zig-Zag phenomenon.(1) Compared with non-restenosis group, the symptom improvement rate was 37.5(vs 74.0%), patients who achieved EF improvement had lower level of based EF. A multiple logistic regression analysis revealed that based EF<60% was independent proctors of the improvements after PCI. (2) Compared with non-restenosis group, the restenosis had more finer minimal lumen diameter (MLD) immediately after PCI (P=0.038) and history of MI (54.2% vs 31.4%, P<0.05). A multiple logistic regression analysis revealed that increase of follow-up time span (P=0.038, OR:1.051), history of MI (P=0.045, OR:3.268), MLD immediately after PCI (P=0.049, OR:0.071) were independent proctors for in stent restenosis (ISR) after PCI. A single and multiple liner regression analysis also revealed that follow-up time span (P=0.006, B:-0.015), MLD immediately after PCI (P=0.000, B:1.146) were independent proctors for follow-up MLD.Conclusions:Percutanenous coronary intervention in patients with a Chronic Total Occlusion can improve the symptoms and cardiac function. Based EF<60% was independent proctors of the improvements after PCI. History of MI and MLD immediately after PCI were independent proctors of in stent restenosis (ISR) after PCI. MLD immediately after PCI were also the independent proctors for follow-up MLD.