Skip to main content

Advertisement

SpringerLink
Log in

Long-Term Clinical Outcomes after Percutaneous Coronary Intervention for Chronic Total Occlusions

  • Ischemic Heart Disease (D Mukherjee, Section Editor)
  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

Abstract

Optimal treatment of chronic total occlusions (CTOs) remains one of the major challenges in interventional cardiology. A number of factors, including both patient clinical conditions and technical procedural considerations, have been identified to affect percutaneous coronary intervention (PCI) success and long-term outcomes, in large multicenter cohorts as well as smaller patient groups. As opposed to patient-centered factors, technical factors can be managed and as a result, a lot of research aims at improving stent technology and imaging guidance, toward enhancing PCI efficiency, in regards to patient safety.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Explore related subjects

Discover the latest articles, news and stories from top researchers in related subjects.

References

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

  1. Levine GN, Bates ER, Blankenship JC, et al. 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. Circulation. 2011;124:2574–609.

    Article  PubMed  Google Scholar 

  2. Tamburino C, Capranzano P, Capodanno D, et al. Percutaneous recanalization of chronic total occlusions: wherein lies the body of proof? Am Heart J. 2013;165:133–42. Systematic literature review proposing a clinical approach algorithm.

    Article  PubMed  Google Scholar 

  3. Fefer P, Knudtson ML, Cheema AN, et al. Current perspectives on coronary chronic total occlusions: the Canadian Multicenter Chronic Total Occlusions Registry. J Am Coll Cardiol. 2012;59:991–7.

    Article  PubMed  Google Scholar 

  4. Claessen BE, Chieffo A, Dangas GD, et al. Gender differences in long-term clinical outcomes after percutaneous coronary intervention of chronic total occlusions. J Invasive Cardiol. 2012;24:484–8.

    PubMed  Google Scholar 

  5. Hoye A. Management of chronic total occlusion by percutaneous coronary intervention. Heart. 2012;98:822–8.

    Article  PubMed  Google Scholar 

  6. Brilakis ES, Grantham JA, Rinfret S, et al. A percutaneous treatment algorithm for crossing coronary chronic total occlusions. JACC Cardiovasc Interv. 2012;5:367–79. Comprehensive step wised description of the contemporary treatment strategy for CTOs.

    Article  PubMed  Google Scholar 

  7. Uehara Y, Shimizu M, Yoshimura M. A case with successful retrograde stent delivery via AC branch for tortuous right coronary artery. J Invasive Cardiol. 2013;25:E39–41.

    PubMed  Google Scholar 

  8. Strauss BH, Osherov AB, Radhakrishnan S, et al. Collagenase Total Occlusion-1 (CTO-1) trial: a phase I, dose-escalation, safety study. Circulation. 2012;125:522–8.

    Article  CAS  PubMed  Google Scholar 

  9. Syrseloudis D, Secco GG, Barrero EA, et al. Increase in J-CTO lesion complexity score explains the disparity between recanalisation success and evolution of chronic total occlusion strategies: insights from a single-centre 10-year experience. Heart. 2013;99:474–9.

    Article  PubMed  Google Scholar 

  10. Grantham JA, Marso SP, Spertus J, House J, Holmes Jr DR, Rutherford BD. Chronic total occlusion angioplasty in the United States. JACC Cardiovasc Interv. 2009;2:479–86.

    Article  PubMed  Google Scholar 

  11. Suttorp MJ, Laarman GJ, Rahel BM, et al. Primary Stenting of Totally Occluded Native Coronary Arteries II (PRISON II): a randomized comparison of bare metal stent implantation with sirolimus-eluting stent implantation for the treatment of total coronary occlusions. Circulation. 2006;114:921–8.

    Article  PubMed  Google Scholar 

  12. Garcia S, Brilakis ES. Optimal stenting strategy for coronary chronic total occlusion interventions: what is next? Catheter Cardiovasc Interv. 2013;81:800–1.

    Article  PubMed  Google Scholar 

  13. Uehara Y, Shimizu M, Yoshimura M. A case of CTO treated with minimum use of contrast media. Catheter Cardiovasc Interv. 2013;82:E884–7.

    Google Scholar 

  14. Park KW, Kang SH, Yang HM et al. Impact of intravascular ultrasound guidance in routine percutaneous coronary intervention for conventional lesions: data from the EXCELLENT trial. Int J Cardiol. 2013;167:721–6.

    Google Scholar 

  15. Jones DA, Weerackody R, Rathod K, et al. Successful recanalization of chronic total occlusions is associated with improved long-term survival. JACC Cardiovasc Interv. 2012;5:380–8.

    Article  PubMed  Google Scholar 

  16. Hoebers LP, Claessen BE, Dangas GD, et al. Long-term clinical outcomes after percutaneous coronary intervention for chronic total occlusions in elderly patients (>/=75 years): five-year outcomes from a 1,791 patient multi-national registry. Catheter Cardiovasc Interv. 2013;82:85–92.

    Article  PubMed  Google Scholar 

  17. Michael TT, Karmpaliotis D, Brilakis ES et al. Impact of prior coronary artery bypass graft surgery on chronic total occlusion revascularisation: insights from a multicentre US registry. Heart. 2013;99:1515–8.

    Google Scholar 

  18. Safley DM, House JA, Marso SP, Grantham JA, Rutherford BD. Improvement in survival following successful percutaneous coronary intervention of coronary chronic total occlusions: variability by target vessel. JACC Cardiovasc Interv. 2008;1:295–302.

    Article  PubMed  Google Scholar 

  19. Claessen BE, Dangas GD, Godino C, et al. Impact of target vessel on long-term survival after percutaneous coronary intervention for chronic total occlusions. Catheter Cardiovasc Interv. 2013;82:76–82.

    Article  PubMed  Google Scholar 

  20. Hochman JS, Lamas GA, Buller CE, et al. Coronary intervention for persistent occlusion after myocardial infarction. N Engl J Med. 2006;355:2395–407.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. Murarka S, Heuser RR. Chronic total occlusions: successful recanalization of very old lesions. Catheter Cardiovasc Interv. 2013;81:802–9.

    Article  PubMed  Google Scholar 

  22. Claessen BE, Dangas GD, Weisz G, et al. Prognostic impact of a chronic total occlusion in a non-infarct-related artery in patients with ST-segment elevation myocardial infarction: 3-year results from the HORIZONS-AMI trial. Eur Heart J. 2013;33:768–75. Important CTO group related subanalysis from the HORIZONS-AMI trial.

    Article  Google Scholar 

  23. Bataille Y, Dery JP, Larose E, et al. Prevalence, predictors and clinical impact of unique and multiple chronic total occlusion in non-infarct-related artery in patients presenting with ST-elevation myocardial infarction. Heart. 2012;98:1732–7.

    Article  PubMed  Google Scholar 

  24. De Felice F, Fiorilli F, Parma A, Musto C, Nazzaro MS, Confessore P, Scappaticci M, Violini R. Effect of multivessel coronary artery disease with or without a concomitant chronic total occlusion on 1-year survival in patients treated with rescue angioplasty. J Invasive Cardiol. 2013;25:64–8.

    Google Scholar 

  25. Godino C, Bassanelli G, Economou FI, et al. Predictors of cardiac death in patients with coronary chronic total occlusion not revascularized by PCI. Int J Cardiol. 2013. doi:10.1016/j.ijcard.2012.12.044.

    Google Scholar 

  26. Bataille Y, Plourde G, Machaalany J, Abdelaal E, Déry JP, Larose E, Déry U, Noël B, Barbeau G, Roy L, Costerousse O, Bertrand OF. Interaction of chronic total occlusion and chronic kidney disease in patients undergoing primary percutaneous coronary intervention for acute ST-elevation myocardial infarction. Am J Cardiol. 2013;112:194–9.

    Google Scholar 

  27. Claessen BE, Dangas GD, Godino C, et al. Long-term clinical outcomes of percutaneous coronary intervention for chronic total occlusions in patients with versus without diabetes mellitus. Am J Cardiol. 2011;108:924–31.

    Article  PubMed  Google Scholar 

  28. Liu W, Wagatsuma K, Nii H, Toda M, Amano H, Uchida Y. Impact of diabetes on long term follow-up of elderly patients with chronic total occlusion post percutaneous coronary intervention. JGC. 2013;10:16–20.

    PubMed  Google Scholar 

  29. Mehran R, Aymong ED, Nikolsky E, et al. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. J Am Coll Cardiol. 2004;44:1393–9.

    PubMed  Google Scholar 

  30. Valenti R, Vergara R, Migliorini A, Parodi G, Carrabba N, Cerisano G, Dovellini EV, Antoniucci D. Predictors of reocclusion after successful drug-eluting stent-supported percutaneous coronary intervention of chronic total occlusion. J Am Coll Cardiol. 2013;61:545–50.

    Google Scholar 

  31. Hur SH, Ako J, Honda Y, Sudhir K, Fitzgerald PJ. Late-acquired incomplete stent apposition: morphologic characterization. Cardiovasc Revasc Med. 2009;10:236–46.

    Article  PubMed  Google Scholar 

  32. Hur SH, Kang SJ, Kim YH, Ahn JM, Park DW, Lee SW, Yun SC, Lee CW, Park SW, Park SJ. Impact of intravascular ultrasound-guided percutaneous coronary intervention on long-term clinical outcomes in a real world population. Catheterization and cardiovascular interventions: official J Soc Card Angiography Interv. 2013;81:407–16.

  33. Guo J, Maehara A, Guo N, Ashida K, Chirumamilla A, Shang Y, Pu J, Sanidas E, Moses JW, Leon MB, Weisz G, Stone GW, Mintz GS, Ochiai M. Virtual histology intravascular ultrasound comparison of coronary chronic total occlusions versus non-occlusive lesions. Int J Cardiovasc Imaging. 2013;29:1249–54.

    Google Scholar 

  34. Khan MF, Wendel CS, Thai HM, Movahed MR. Effects of percutaneous revascularization of chronic total occlusions on clinical outcomes: a meta-analysis comparing successful versus failed percutaneous intervention for chronic total occlusion. Catheter Cardiovasc Interv. 2013;82:95–107. Large metanalysis showing the superiority of PCI over medical treatment.

    Article  PubMed  Google Scholar 

  35. Gada H, Whitlow PL, Marwick TH. Establishing the cost-effectiveness of percutaneous coronary intervention for chronic total occlusion in stable angina: a decision-analytic model. Heart. 2012;98:1790–7.

    Article  PubMed  Google Scholar 

  36. Niccoli G, Ferrante G, Galassi AR, Montone RA, Crea F. Optical coherence tomography follow-up of the subintimal tracking and re-entry technique for chronic total occlusion. EuroIntervention. 2010;6:662–3.

    Article  PubMed  Google Scholar 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

Spyretta Golemati declares that she has no conflict of interest.

Elias A. Sanidas declares that he has no conflict of interest.

George D. Dangas has been a consultant for Abbott Vascular, Boston Scientific, Medtronic; has received grant support from Medicines Co., Abbott Vascular, Eli Lilly; has received honoraria from AstraZeneca, Bristol-Myers Squibb, Sanofi, and Janssen.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

  1. Columbia University Medical Center and New York Presbyterian Hospital, New York, NY, USA

    Spyretta Golemati

  2. Cardiovascular Research Foundation, 111 East 59th street 12th floor, New York, NY, 10022, USA

    Elias A. Sanidas & George D. Dangas

  3. Mount Sinai Medical Center, New York, NY, USA

    George D. Dangas

  4. Cardiovascular Innovation, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029-6574, USA

    George D. Dangas

  5. Department of Biomedical Engineering, Columbia University, New York, NY, USA

    Spyretta Golemati

  6. Ultrasound Elasticity Imaging Laboratory Columbia University Medical Campus, 630 West 168th Street Physicians & Surgeons 19-418, New York, NY, 10032, USA

    Spyretta Golemati

Authors
  1. Spyretta Golemati
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elias A. Sanidas
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. George D. Dangas
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to George D. Dangas.

Additional information

This article is part of the Topical Collection on Ischemic Heart Disease

Rights and permissions

Reprints and permissions

About this article

Cite this article

Golemati, S., Sanidas, E.A. & Dangas, G.D. Long-Term Clinical Outcomes after Percutaneous Coronary Intervention for Chronic Total Occlusions. Curr Cardiol Rep 16, 450 (2014). https://doi.org/10.1007/s11886-013-0450-7

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11886-013-0450-7

Keywords

Search

Navigation