Effect of Chronic Total Coronary Occlusion on Treatment Strategy

Ryan D. Christofferson, MD, Kenneth G. Lehmann, MD, Gary V. Martin, MD, Nathan Every, MD, James H. Caldwell, MD, and Samir R. Kapadia, MD

In a registry analysis of 8,004 consecutive patients presenting for diagnostic catheterization at a single institution from 1990 to 2000, chronic total occlusion (CTO) was found in 52% of patients with significant (> or = 70% diameter stenosis) coronary artery disease. Peripheral vascular disease was the strongest clinical predictor of the presence of a CTO. In a multivariate analysis, CTO was the strongest predictor against the selection of percutaneous coronary intervention (PCI) as a treatment strategy, indicating that efforts to improve the success rate of PCI in CTO may have a significant impact on management of coronary disease.

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