Determinants of percutaneous coronary intervention success in repeat chronic total occlusion procedures following an initial failed attempt

Table 1 Baseline patient characteristics

Patient demographics	Overall (n = 58)	Success (n = 40)	Failure (n = 18)	P value
Age, yr	59.2 ± 11.6	59.2 ± 11.6	60.2 ± 11.7	0.78
Male	50 (86.2%)	33 (82.5%)	17 (94.4%)	0.41
Obesity	20 (34.4%)	14 (35%)	6 (33.3%)	1
Hypertension	39 (67.2%)	24 (60%)	15 (83.3%)	0.15
Dyslipidaemia	41 (70.6%)	27 (67.5%)	14 (77.8%)	0.63
Diabetes	23 (39.6%)	15 (37.5%)	8 (44.4%)	0.84
Smoking	38 (65.5%)	26 (65%)	12 (66.7%)	1
Previous MI	22 (37.9%)	15 (37.5%)	7 (38.9%)	1
Previous PCI	27 (46.6%)	17 (42.5%)	10 (55.6%)	0.52
Previous CABG	2 (3.4%)	1 (2.5%)	1 (5.6%)	0.52
LVEF < 45%	22 (37.9%)	15 (37.5%)	7 (38.9%)	1
CKD IV	3 (5.2%)	3 (7.5%)	0 (0%)	0.55

MI: Myocardial infarction; PCI: Percutaneous coronary intervention; CABG: Coronary artery bypass grafting; LVEF: Left ventricular ejection fraction; CKD: Chronic kidney disease.

Table 2 Angiographic characteristics

Angiographic characteristics	Overall (n = 64)	Success (n = 41)	Failure (n = 23)	P value
CTO Site				0.0045
LAD	27 (42.2%)	21 (51.5%)	6 (26.1%)
RCA	31 (48.4%)	16 (39.0%)	15 (65.2%)
LCx	6 (9.4%)	4 (9.7%)	2 (8.7%)
Blunt stump	19 (29.7%)	10 (24.3%)	9 (39.1%)	0.34
Tortuous vessel	23 (35.9%)	12 (29.2%)	11 (47.8%)	0.225
Calcified lesion	11 (17.2%)	4 (9.7%)	7 (30.4%)	0.047
Lesion length > 20 mm	49 (93.8%)	30 (73.1%)	19 (82.6%)	0.58
J-CTO Score	2.9 ± 0.92	2.73 ± 0.84	3.2 ± 0.99	0.0063
J-CTO 1	4 (6.25%)	3 (7.3%)	1 (21.4%)	1
J-CTO 2	18 (28.1%)	12 (29.3%)	6 (26.1%)	1
J-CTO 3	22 (34.4%)	19 (46.3%)	3 (39.1%)	0.015
J-CTO 4	20 (31.2%)	7 (17.1%)	13 (56.5%)	0.0028
Rentrop class 3	43 (67.2%)	26 (48.8%)	17 (73.9%)	0.56
Segment
Distal	4 (6.2%)	2 (4.9%)	2 (8.7%)	0.61
Mid	27 (42.2%)	16 (39.0%)	11 (47.8%)	0.67
Proximal	33 (51.6%)	23 (56.1%)	10 (43.5%)	0.47
Segment length	26.95 ± 12.2	25.4 ± 10.3	29.7 ± 14.9	0.23
Presence of proximal disease	15 (23.4%)	9 (21.9%)	6 (26.1%)	0.95

LAD: Left anterior descending; LCx: Left circumflex; RCA: Right coronary artery; CTO: Chronic total occlusions; J-CTO: Japanese chronic total occlusion.

Table 3 Procedural characteristics

Procedural characteristics	Overall (n = 64)	Success (n = 41)	Failure (n = 23)	P value
Planned initial attempt	45 (70.3%)	29 (70.7%)	16 (69.6%)	1
Retrograde approach	9 (14.1%)	6 (14.6%)	3 (13.0%)	1
Contralateral injection	36 (56.3%)	22 (53.6%)	14 (60.9%)	0.76
Parallell wire	16 (25%)	10 (24.3%)	6 (26.1%)	1
Intravascular ultrasound	8 (12.5%)	8 (19.5%)	0 (0%)	0.042
Rotablator	5 (7.8%)	5 (12.2%)	0 (0%)	0.15
Change of operator	39 (60.9%)	27 (65.9%)	12 (52.2%)	0.41
Experienced operator	36 (56.3%)	27 (65.9%)	9 (39.1%)	0.065
Change in guide catheter	11 (17.2%)	7 (17.1%)	4 (17.4%)	1
Change of wire	38 (59.4%)	23 (56.1%)	15 (65.2%)	0.65
Microcatheter use	46 (71.9%)	28 (68.3%)	18 (78.3%)	0.57
Procedure time	127.8 ± 44.3	129.1 ± 51.3	125.3 ± 32.8	0.71
Fluroscopy time	45.44 ± 21	43.3 ± 21.5	49.2 ± 20.0	0.27
Contrast (mL)	337.5 ± 127.5	355.5 ± 127.2	305.4 ± 124.3	0.13

Table 4 Predictors of procedural success/failure

Variable	Coefficient (b)	SD (b)	95%CI	P (b ≠ 0 | data)	P value
J-CTO ≤ 3	0.26	0.52	-2.04	0.69	0.31
J-CTO > 3	-1.67	0.67	-3.34	0.99	0.01
LAD	0.9	0.6	-2.36	0.93	0.07
IVUS use	2.96	1.58	-6.2	0.97	0.03
Experienced operator	0.78	0.58	-2.28	0.91	0.09

LAD: Left anterior descending, J-CTO: Japanese chronic total occlusion; IVUS: Intravascular ultrasound.