Early and late outcome of percutaneous transluminal coronary angioplasty for subacute and chronic total coronary occlusion.

Percutaneous transluminal coronary angioplasty (PTCA) for nonacute total coronary occlusion was performed in 46 patients, with a 63% primary success rate (29 of 46 procedures). There were no acute myocardial infarctions and no deaths in the study group. There was no difference in success rate according to vessel dilated, prior myocardial infarction, or lesion morphology. The success rate with occlusions less than 2 weeks' duration was 14 of 19 (74%) vs 15 of 27 (55%) with occlusions greater than 2 weeks' duration (p = NS). There was clinical recurrence in 14 of 29 (48%). Factors predictive of recurrence included a greater residual post-PTCA stenosis of 47 +/- 6% in recurrences vs 31 +/- 3% in nonrecurrences (p less than 0.025), while estimated duration of initial occlusion was 1.1 +/- 0.4 months for recurrences vs 3.1 +/- 1 months for nonrecurrences (p = 0.07). PTCA for total occlusion has a lower success rate and higher recurrence rate than PTCA for nontotal stenoses. Recurrence appears to be related to a higher degree of post-PTCA residual narrowing and to a shorter duration of initial occlusion.