Evaluating the frequency of successful guidewire crossing through a complex lesion in coronary artery disease patients having chronic total occlusion

Waheed Akhtar; Syed Tehseen Shahzad; Shahzad Hasrat; Waqar Mustafa

doi:10.12669/pjms.38.5.4770

Waheed Akhtar Abbas Institute of Medical Sciences, Muzaffarabad Azad Jammu and Kashmir
Syed Tehseen Shahzad Abbas Institute of Medical Sciences, Muzaffarabad Azad Jammu and Kashmir
Shahzad Hasrat Abbas Institute of Medical Sciences, Muzaffarabad Azad Jammu and Kashmir
Waqar Mustafa Abbas Institute of Medical Sciences, Muzaffarabad Azad Jammu and Kashmir

DOI: https://doi.org/10.12669/pjms.38.5.4770

Keywords: Angioplasty, Chronic Total Occlusion, Coronary Artery Disease, Percutaneous Coronary Intervention, Stents and J-CTO score

Abstract

Objectives: To determine the frequency of successful guidewire crossing through chronic total occlusion (CTO) in patients having a J-CTO Score = 2 (difficult lesion).

Methods: A prospective, cross-sectional study was conducted at the Armed Forces Institute of Cardiology (AFIC) in Rawalpindi. Patients with high calcium score on CT-angiogram were sent for elective coronary angiogram out of which patients diagnosed with chronic total occlusion (CTO) were selected and J-CTO Score was assessed. Those with a J-CTO score = 2 (difficult lesion) were enrolled for percutaneous coronary intervention (PCI). Guidewire that can cross the lesion within 30 minutes was considered successful.

Results: A total of 158(95.8%) cases had successful guidewire crossing, while in 7(4.2%) patients, the procedure was unsuccessful. No significant association between the success rate of guidewire crossing and age (p = 0.21). Furthermore, there was no statistically significant relationship between guidewire crossing and LV function (p = 0.559) i.e. 32.2% and 42.9% of those with LV function between 25-35% had successful and unsuccessful guidewire crossing, respectively. While 67.7% and 57.1% patients having 36-65% LV function were observed having successful and failed PCI, respectively.

Conclusions: The success rate of guidewire crossing through CTO in patients having a J-CTO Score =2 (difficult lesion) is acceptable so J-CTO score can be considered for difficulty grading of the lesion before intervention to prevent complications and success rate of PCI.

doi: https://doi.org/10.12669/pjms.38.5.4770

How to cite this:
Akhtar W, Shah ST, Hasrat S, Mustafa W. Evaluating the frequency of successful guidewire crossing through a complex lesion in coronary artery disease patients having chronic total occlusion. Pak J Med Sci. 2022;38(5):1113-1117. doi: https://doi.org/10.12669/pjms.38.5.4770

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