Use of vibrational angioplasty for the treatment of chronic total coronaryocclusions: Preliminary results

The aim of the study was to investigate the feasibility and clinical safety of vibrational angioplasty in the treatment of chronic total coronary occl usions and evaluate the clinical and angiographic factors that are predicti ve of the procedural success and complications of the procedure. Seventy-ei ght patients with chronic total occlusions (>3 months) resistant to convent ional techniques were treated by vibrational angioplasty using a variety of conventional guidewires. Lesions were successfully crossed in 67 (85.9%) c ases and antegrade flow was achieved in 59 (75.5%). Major complications (my ocardial infarction and tamponade) occurred in two (2.5%) patients, but no fatalities ensued. Angiographically detectable dissections were seen in 23 (29.5%) patients but only resulted in vessel compromise and reclosure in 5 cases. Multiple stepwise logistic regression analysis identified the durati on (<6 months, P = 0.008) and the length of the occlusion (<15 mm, P = 0.03 ) as independent predictors of final success and the age of the patient (<5 5 years, P = 0.006) as the only independent predictor of procedural complic ations. Vibrational angioplasty is a safe technique useful in the treatment of chronic coronary occlusive disease. Patients in whom the procedure is l ikely to prove most successful may be easily identified by clinical and ang iographic features (duration and length of occlusion). (C) 1999 Wiley-Liss, Inc.