Analysis of survival and changes in clinical status of patients with coronary artery disease after endovascular recanalization of chronic occlusion of the right coronary artery
Background: Procedures performed in chronic coronary artery occlusion comprise from 10 to 20% of all transcutaneous coronary interventions, and their efficacy can amount to 90%. Despite this, their appropriateness for this type of disease is still a matter of debate. Aim: To assess efficacy and safety of interventions compared to medical treatment in patients with isolated chronic occlusion of the right coronary artery. Materials and methods: We analyzed results of treatment of 72 patients. From these, endovascular recanalization of chronic occlusion of the right coronary artery was performed in 39 patients (group 1), the rest 33 patients received medical treatment only (group 2). Clinical state parameters and adverse event rate were assessed during a follow-up of 12 months. Results: After 1 year, a notable reduction of functional grade (FG) of exertional angina was seen in the group 1. The number of patients with FG I increased from 3 (7.7%) to 20 (51.3%), р < 0.05; and the number of those with FG III decreased from 22 (56.4%) to 6 (15.4%), р < 0.05. No significant changes of FG of angina were seen in the group 2 (control group) after 2 and 12 months (р > 0.05 at both time points). At 1 year, 94.9% (95% CI: 88,2-99,9%) of patients from the group 1 and 100% of patient in the group 2 were free of adverse clinical events. Conclusion: Transcutaneous coronary angioplasty for chronic occlusion of the right coronary artery significantly improves clinical course of ischemic heart disease at 2 and 12 months, compared to medical treatment, by decreasing FG of exertional angina. From clinical point of view, adverse events reported in the group of endovascular recanalization for chronic occlusion of the right coronary artery are insignificant.