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Update in the Percutaneous Management of Coronary Chronic Total Occlusions |
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| Authors: | Peter Tajti M. Nicholas Burke Dimitri Karmpaliotis Khaldoon Alaswad Gerald S. Werner Lorenzo Azzalini Mauro Carlino Mitul Patel Kambis Mashayekhi Mohaned Egred Oleg Krestyaninov Dmitrii Khelimskii William J. Nicholson Imre Ungi Alfredo R. Galassi Subhash Banerjee Emmanouil S. Brilakis |
| Affiliation: | 1. Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota;2. Division of Invasive Cardiology, University of Szeged, Second Department of Internal Medicine and Cardiology Center, Szeged, Hungary;3. Department of Cardiology, Columbia University, New York, New York;4. Department of Cardiology, Henry Ford Hospital, Detroit, Michigan;5. Medizinische Klinik I (Cardiology and Intensive Care), Klinikum Darmstadt GmbH, Darmstadt, Germany;6. Division of Interventional Cardiology, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy;7. Department of Cardiology, UC San Diego Sulpizio Cardiovascular Center and VA San Diego Healthcare System, La Jolla, California;8. Division of Cardiology and Angiology II, University Heart Center Freiburg Bad Krozingen, Bad Krozingen, Germany;9. Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom;10. Meshalkin Siberian Federal Biomedical Research Center, Ministry of Health of Russian Federation, Novosibirsk, Russian Federation;11. Department of Cardiology, WellSpan York Hospital, York, Pennsylvania;12. Department of Medical Sciences and Pediatrics, Catheterization Laboratory and Cardiovascular Interventional Unit, Cannizzaro Hospital, University of Catania, Catania, Italy;13. VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas |
| Abstract: | Percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs) has been rapidly evolving during recent years. With improvement in equipment and techniques, high success rates can be achieved at experienced centers, although overall success rates remain low. Prospective, randomized-controlled data regarding optimal use and indications for CTO PCI remain limited. CTO PCI should be performed when the anticipated benefit exceeds the potential risk. New high-quality studies of the clinical outcomes and techniques of CTO PCI are needed, as is the expansion of expert centers and operators that can achieve excellent clinical outcomes in this challenging patient and lesion subgroup. In the current review the authors summarize the latest publications in CTO PCI and provide an overview of the current state of the field. |
| Keywords: | chronic total occlusion percutaneous coronary intervention stable coronary artery disease CABG coronary artery bypass grafting CTA computed tomography angiography CTO chronic total occlusion IVUS intravascular ultrasound MACE major adverse cardiac event(s) MT medical therapy OMT optimal medical therapy PCI percutaneous coronary intervention |
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