Research Article
Ostial Lesions Are Associated with More Complexity and Lower Success Rate in Chronic Total Occlusion Percutaneous Interventions
Basem Salloum*
,
Yeliz Koc,
Steffen Schnupp,
Hesham Mady,
Christian Mahnkopf
Issue:
Volume 11, Issue 5, October 2025
Pages:
63-73
Received:
15 June 2025
Accepted:
7 July 2025
Published:
10 October 2025
DOI:
10.11648/j.ijcts.20251105.11
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Abstract: Aims: We aimed to evaluate the influence of ostial lesions on the predicted probability of success in patients undergoing percutaneous coronary interventions (PCIs) for chronic total occlusions (CTOs). Methods: 245 consecutive patients who underwent CTO PCIs at Coburg Hospital, Coburg, Germany between 2017 and 2023 were included. Patients with and without ostial lesions were compared. Logistic regression models were used to estimate the potential of ostial lesion as additional predictor for success beside J-Score. Results: 245 patients were included. Of those, 48 Patients (19.6%) had ostial lesions. The ostial lesion group exhibited significantly higher pro-B-type natriuretic peptide levels (1644 pg./ml vs. 963 pg./ml, p=0.034) than the non-ostial lesion group. The final success rate was lower in the ostial lesion group than in the non-ostial lesion group (64.6% vs. 81.7%, p=0.018). The ostial lesion group had higher J-scores than the non-ostial lesion group, indicating more complex lesions (median: 2.5 vs. 2.0, p=0.005). Antegrade access was more applied in non-ostial lesion group (89.8% vs. 68.8% p=0.001), whereas retrograde access was more applied in ostial lesion group. (33.3% vs. 7.6%, p=<0.001) A logistic regression analysis showed a statistically significant association between higher J-scores and ostial lesions (OR, 2.4; p=0.003). Conclusion: The presence of ostial CTO is associated with higher lesion complexity and lower technical and procedural success rates. Presence of ostial CTO might be included as an additional factor in the currently used CTO scores to predict the difficulty and success rate of CTO procedure.
Abstract: Aims: We aimed to evaluate the influence of ostial lesions on the predicted probability of success in patients undergoing percutaneous coronary interventions (PCIs) for chronic total occlusions (CTOs). Methods: 245 consecutive patients who underwent CTO PCIs at Coburg Hospital, Coburg, Germany between 2017 and 2023 were included. Patients with and ...
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Review Article
Aerobic Versus Resistance Exercise Training and Coronary Angiogenesis in Elite Football (Soccer) Players: A Systematic Review
Mohsen Davoodi*
Issue:
Volume 11, Issue 5, October 2025
Pages:
74-79
Received:
8 September 2025
Accepted:
22 September 2025
Published:
10 October 2025
DOI:
10.11648/j.ijcts.20251105.12
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Abstract: Coronary angiogenesis, the formation of new micro vessels from pre-existing vasculature, is a crucial adaptive response enhancing myocardial perfusion and potentially reducing cardiovascular risk in athletes. Elite football (soccer) players experience unique hemodynamic loads combining aerobic endurance and anaerobic bursts. This systematic review critically evaluates current evidence comparing the distinct and synergistic effects of aerobic endurance training (AET) and resistance exercise training (RET) on molecular pathways and potential for stimulating coronary angiogenesis in this specific athletic cohort. Analysis of recent literature (primarily 2019-2024) reveals that AET predominantly enhances coronary angiogenesis through chronic elevation of laminar shear stress, significantly up regulating endothelial nitric oxide syntheses (eNOS), vascular endothelial growth factor (VEGF), and hypoxia-inducible factor-1α (HIF-1α) expression. RET, characterized by intermittent high-pressure pulsatile flow, robustly activates mechanosensitive pathways (e.g., PI3K/Akt/mTOR) and increases circulating VEGF and angiopoietin-2, though its direct coronary effects are less documented. Football-specific training inherently blends both modalities, suggesting potential synergy. However, human in vivo evidence for direct coronary angiogenesis remains challenging to obtain; current conclusions rely heavily on peripheral vascular surrogates, animal models, molecular biomarkers, and advanced imaging (CMR perfusion). Future research utilizing novel molecular imaging and sport-specific exercise interventions is paramount to elucidate optimal training prescriptions for maximizing coronary vascular health in elite footballers.
Abstract: Coronary angiogenesis, the formation of new micro vessels from pre-existing vasculature, is a crucial adaptive response enhancing myocardial perfusion and potentially reducing cardiovascular risk in athletes. Elite football (soccer) players experience unique hemodynamic loads combining aerobic endurance and anaerobic bursts. This systematic review ...
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