Current Cardiology Reports

, Volume 12, Issue 5, pp 429–439 | Cite as

Antegrade, Retrograde, and Combination Strategies for Chronic Total Occlusions



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.


Chronic total occlusion Angioplasty Coronary artery disease 

Clinical Trial Acronyms


Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation


Occluded Artery Trial


Total Occlusion Angioplasty Study


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Columbia University Medical CenterNew YorkUSA

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