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Antegrade, Retrograde, and Combination Strategies for Chronic Total Occlusions

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Abstract

Chronic total occlusion (CTO) represents one of the most challenging lesion subsets faced by the interventional cardiologist. CTO is a common problem, being present in more than 30% of patients undergoing coronary angiography. Over the past 10 years, the success rate of recanalization has increased from approximately 50–85%. Developments in guidewire technology, imaging technique, and coronary devices have contributed to the improved prognosis of patients affected by a CTO lesion. Enhancement in antegrade and retrograde techniques of recanalization also result in improved outcomes. Benefits of CTO recanalization may include symptom relief, decreased need for coronary artery bypass graft surgery, improved left ventricular ejection fraction, and in some cases an improved survival.

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Abbreviations

COURAGE:

Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation

OAT:

Occluded Artery Trial

TOAST-GISE:

Total Occlusion Angioplasty Study

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Disclosure

Dr. Philippe Genereux has received lecture honoraria from Edwards Lifesciences. Dr. George Dangas has received consultant and lecture honoraria from research support from Abbott Vascular, Boston Scientific, Medtronic, and Cordis Johnson and Johnson.

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  1. Columbia University Medical Center, 161 Fort Washington Avenue, 5th Floor, New York, NY, 10032, USA

    Philippe Genereux & George Dangas

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  1. Philippe Genereux
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  2. George Dangas
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Correspondence to George Dangas.

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Genereux, P., Dangas, G. Antegrade, Retrograde, and Combination Strategies for Chronic Total Occlusions. Curr Cardiol Rep 12, 429–439 (2010). https://doi.org/10.1007/s11886-010-0131-8

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