RETROGRADE VERSUS ANTEGRADE PERCUTANEOUS CORONARY INTERVENTION OF PATIENTS WITH CHRONIC TOTAL OCCLUSION OF THE CORONARY ARTERIES BY USING CORONARY ANGIOGRAPHY

Saturo Sumitsuji*, Khaled Shokry, Mohamed Mahmoud and Mahmoud Ahmed Abd Elbaset

ABSTRACT

Chronic total occlusion (CTO) of coronary arteries is one of the most challenging percutaneous coronary intervention (PCI), usually defined as more than three-month-old obstruction of a native coronary artery(CA). Only 7-15% of CTOs were treated with PCI. Despite these obstacles, several studies have documented that successful PCI of CTOs leads to an improvement in anginal status, normalization of functional tests, improvement of left ventricular (LV) functions and avoidance of coronary artery bypass graft surgery (CABG). Nowadays, specifically trained operators are able to improve the rate of CTO recanalization thanks to several new techniques and dedicated device developments. In particular, the retrograde CTO PCI approach that was first mastered by Japanese operators has evolved rapidly, resulting in higher success rates, shortened procedural time and reduced exposure to radiation. Aim of the study: to evaluate the Differences between the Antegrade and Retrograde PCI in the patients with CTO of the coronary arteries in the success rate, TIMI grade flow, procedural characteristics, angiographic characteristics, and complication, by Coronary Angiography. Patients and methods: The study was conducted through the period from October 2010 to May 2013and included 30 patients, 30 (100 %) males with age from 40 to 67 years old. CTO lesions were treated with help from expert interventional cardiologist, Japanese expert at kopri elkopa military hospitals. Inclusion criteria: 30 Patients have chronic total occlusion of their coronary arteries Exclusion criteria: - Patients with end stage renal disease. - Patients with end stage liver disease. - Heamodynamicaly unstable patients. - Patients with acute coronary syndrome. - Patients with decompensated heart failure.

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