Recanalization of chronically occluded coronary arteries: Single-center experience in 400 cases, including long-term angiographic follow-up

The study presented comprises the initial and angiographic long-term results of a consecutive series of recanalization procedures in a single center. Between 1988 and 1992, a total of 400 patients underwent transluminal recanalization for total coronary occlusions. In 82% of successfully attempted patients, the occlusion could be passed by a standard guidewire. The overall initial success rate was 75% (298 of 400). The highest success rates could be achieved in the left circumflex artery (84%) and left anterior descending coronary artery (77%). Complications were uncomplicated myocardial infarction in ten patients (2.5%) and death in two patients (0.5%). Angiographic follow-up 3-6 months after recanalization could be achieved in 263 (88%) of 298 patients. Significant restenosis (greater than or equal to 50% minimum lumen diameter) was found in 57 (22%) of 263, and reocclusion was present in 38 (14%) of 263 patients, resulting in a total recurrence rate of 36%. In conclusion, recanalization can be performed with an initial success rate of 75% using bare-wire technique under the prerequisite operator experience. If a nearly complete angiographic follow-up is performed, the overall recurrence rate is 36%, which seems to be very acceptable in comparison with PTCA results for incomplete obstructions published so far.