Percutaneous Transluminal Coronary Angioplasty of Occluded Coronary Arteries: New Angiographic Features Related to Success

Percutaneous transluminal coronary angioplasty of coronary artery occlusions forms a routine part of cardiological practice. However, only a few angiographic variables which might predict success have been investigated and identified. Video densitometry was used to assess structural features of the occlusion that have not been investigated previously. The sharpness and eccentricity of the tapering, the presence of any distal vessel and the presence of a reservoir or atrium in which the end of the wire could become trapped were measured. Other measurements taken from the cineangiogram included the minimum radius of curvature of the artery immediately before the occlusion, the number of bends and the distance traversed before the occlusion. The number, size, location and angle of branching of side branches from the artery in question were noted. The number of bridging collaterals and presence of distal opacification were noted. There was a significantly higher success rate in patients with less than 3 bends before the occlusion (p=0.01) and a distance down the artery to the occlusion of less than 27mm (p