Percutaneous coronary intervention (PCI) for chronic @entity432 (CTO) is still technically challenging. The use of tapered-tip guidewires in these lesions may improve the success rate of PCI. In order to avoid the needless radiation exposure or contrast consumption, we have to determine a guideline for the termination of procedures in these lesions. We retrospectively analyzed the data of 182 @entity1 between April 1997 and December 1999 (phase 1) and 80 @entity1 between January and August 2001 (phase 2) who underwent angioplasty for CTO lesions >/= 3 months. There were no significant differences in clinical or lesion characteristics except the use of tapered-tip guidewires. Tapered-tip guidewires were used in 60% of @entity1 in phase 2 period but no @entity1 in phase 1 period. The overall success rate of PCI was improved from 67% in phase 1 to 81% in phase 2 (P = 0.019). In the phase 2 period, the success rate was higher in tapered-type occlusion (P = 0.002) and shorter length of occlusion (P = 0.004). Total procedure time was 46 +/- 17 min and total volume of contrast dye was 180 +/- 63 ml. The success rate was higher in @entity1 treated by transradial coronary intervention (TRI) than transfemoral coronary intervention (89% vs. 64%; P = 0.008). The use of tapered-tip guidewires can improve the success rate of PCI in CTO lesions. The following guideline for the termination of the procedures is reasonable: time from arterial access to successful penetration of a guidewire through occlusion </= 30 min; total procedure time </= 90 min; and total dye volume </= 300 ml. TRI can achieve a high success rate even in CTO lesions provided that the case selection is adequate.

Angioplasty for chronic XXXX by using tapered-tip guidewires.

@entity432 :: ('MESH:D001157', 'Disease') :: ['total occlusion'] @entity1 :: ('9606', 'Species') :: ['patients']
@entity432 :: (MESH:D001157,Disease) :: ['total occlusion']
