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Contemporary Approach to Chronic Total Occlusion Interventions

  • Coronary Artery Disease (D Feldman and V Voudris, Section Editors)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Abstract

Purpose of review

Chronic total occlusion (CTO) poses one of the greatest technical challenges to interventional cardiologists. Despite recent advancements in techniques and clinical trials showing significant benefits of CTO percutaneous coronary interventions (PCI), the proportion of patients with untreated CTOs remains high. We therefore aim to perform a comprehensive review of the various techniques available, recent advancements, benefits, and complications associated with CTO PCI.

Recent findings

Three randomized clinical trials examining the benefits of CTO PCI have recently been presented. Scoring systems have been developed to facilitate pre-procedural estimation of success and complications of CTO PCI. Technological enhancements in coronary wires and other interventional equipment along with dedicated training for CTO operators have improved the likelihood of successful recanalization of CTOs.

Summary

CTO PCI has been shown to improve patient symptoms and quality of life. It is therefore important to have an in-depth knowledge of the various CTO techniques, appropriate equipment, and complications when performing these complex procedures. Clinicians should weigh the risks and benefits and choose the appropriate patient population who may benefit from revascularization.

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References and Recommended Reading

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Authors and Affiliations

  1. Division of Cardiovascular Disease, Department of Medicine, University of Minnesota, Minneapolis, MN, USA

    Mahesh Anantha-Narayanan MD

  2. Minneapolis Heart Institute at Abbott Northwestern Hospital, 920 E 28th Street, Suite 300, Minneapolis, MN, 55407, USA

    Santiago Garcia MD

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Mahesh Anantha Narayanan declares no potential conflicts of interest. Santiago Garcia is a consultant for Surmodics, Osprey medical, Medtronic, Edwards Lifesciences, Abbott and Boston Scientific. Research grants from Edwards Life Sciences, Minnesota Veterans Research Foundation and VA Office of Research and Development.

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Anantha-Narayanan, M., Garcia, S. Contemporary Approach to Chronic Total Occlusion Interventions. Curr Treat Options Cardio Med 21, 1 (2019). https://doi.org/10.1007/s11936-019-0704-9

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