LAUSR

INTRODUCTION Current guidelines for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) recommend dual coronary angiography. AIM OF THE STUDY Evaluate CTO-PCI with a single approach using safety indices through the microcatheter. POPULATION AND METHODS Prospective observational study with a consecutive inclusion of 39 patients (mean age of 67 years) treated by antegrade approach without scheduled contralateral angiography. Following safety indices were collected: blood backflow, distal coronary pressure waveform, selective distal contrast injection. RESULTS Technical success was obtained in 90% of the cases. Balloon dilation was used in 38% of the cases before placement of the microcatheter. Dual angiography was necessary in three cases (8%). A blood backflow and cyclic changes of the distal coronary pressure waveform were noticed in 87% and 84% of the cases, with a positive predictive value of 97% and 79% respectively, for a microcatheter location in the true lumen. Selective distal contrast injection was done in 36 cases with a visualization of the true lumen in 35 cases. One major complication was observed (3%). CONCLUSION CTO-PCI with a single approach is feasible using safety indices to limit the risks of major complication. The principle of a systematic dual angiography as advocated in current guidelines may deserve to be revisited.