TY - JOUR ID - TI - Chronic Total Occlusion Anatomy and Characteristics of Coronary Collaterals and Angiographic Features Predicting the Success of Chronic Total Occlusion Intervention AU - Shiekh Rayees AU - Aashaq Hussain Khandy AU - Tauseef Nabi AU - Sajaad Manzoor PY - 2022 VL - 19 IS - 1 SP - 81 EP - 88 JO - Medical Journal of Babylon مجلة بابل الطبية SN - 1812156X 23126760 AB - Background and Objective: Angiographic assessment of chronic total occlusion (CTO) anatomy and collateral characteristics ofcoronary arteries are necessary for CTO intervention. Materials and Methods: This was a hospital-based observational study of 100coronary angiograms (CAG) with CTOs. CTO anatomy and collateral characteristics of coronary arteries were studied for predictinganterograde and retrograde CTO intervention. Results: Right coronary artery (RCA) CTO was the most common (62%), followed byleft anterior descending (LAD). More than two-thirds of RCA and LAD CTO lesions were >20 mm and half were in mid-segment.Left circumflex artery (LCX) and RCA lesions were more frequently calcified. LAD CTOs often had blunt stump; LCX CTOsfrequently had bending >45°. The mean J-CTO score was lowest in RCA CTOs (2.0 ± 1.19). There were 10 different types of collateralsin RCA CTOs, 8 in LAD CTOs, and only 4 in LCX CTOs. The most common RCA CTOs collateral was LAD septal to the rightposterior descending artery (RPDA) (69.4%) and in LAD CTOs, the most common was septal collaterals from the RPDA to LAD(40.9%). RCA CTOs had a higher percentage of septal collaterals, less tortuosity, and favorable entry and exit angle when comparedwith other two arteries. Conclusion: RCA CTOs were the most common. Angiographic features in CTO lesions vary among threemajor coronary arteries. The RCA CTOs had lesser mean J-CTO score, more number of septal collaterals, less tortuous collaterals,and favorable entry and exit angle. RCA CTOs were better accessible for anterograde and retrograde intervention.

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