CHRONIC CORONARY OCCLUSIONS - AGE, MORPHOLOGY AND CHANCE OF REOPENING

In chronic coronary occlusions the chance of successful reopening by a ngioplasty can be judged from the age of the occlusion. Often, however , time since occlusion cannot be accurately assessed. Therefore we det ermined whether the chance of reopening can be predicted from angiogra phic morphology. In cineangiograms from 60 consecutive patients with c hronic coronary occlusions morphological details in at least two proje ctions were evaluated in relation to the rate of success and the estim ated age of occlusion. Morphological features associated with a higher rate of success (type A) were a clearcut proximal stump, absence of s ide branches at the site of occlusion, absence of bridging collaterals , and only slight filling of the distal part of the vessel. Features a ssociated with a low success rate (type B) were absence of proximal st ump, side branches at the site of occlusion, bridging collaterals, and rapid high-contrast filling of the distal part of the vessel. 48/60 ( 80%) of occlusions could be classified as type A or type B. The succes s rate was 17/21 (81%) in type A versus 5/27 (18.5%) in type B (P < 0. 0002). The estimated age of type B occlusions was higher than that of type A-medians 8 and 4 months (P < 0.002). Thus in chronic coronary oc clusions the likelihood of successful reopening can be judged in many patients from morphological features.