Percutaneous treatment of coronary chronic total occlusions part 1: Rationale and outcomes

Alfredo Galassi, Aaron Grantham, David Kandzari, William Lombardi, Issam Moussa, Craig Thompson, Gerald Werner, Charles Chambers, Emmanouil Brilakis

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Coronary chronic total occlusions (CTOs) are commonly encountered in patients with coronary artery disease. Compared to patients without coronary CTOs, those with CTO have worse clinical outcomes and lower likelihood of complete coronary revascularisation. Successful CTO percutaneous coronary intervention (PCI) can significantly improve angina and improve left ventricular function. Although currently unproven, successful CTO PCI might also reduce the risk for arrhythmic events in patients with ischaemic cardiomyopathy, provide better tolerance of future acute coronary syndrome, and possibly improve survival. Evaluation by a heart team comprised of both interventional and non-interventional cardiologists and cardiac surgeons is important for determining the optimal revascularisation strategy in patients with coronary artery disease and CTOs. Ad hoc CTO PCI is generally not recommended, so as to allow sufficient time for (a) discussion with the patient about the indications, goals, risks, and alternatives to PCI; (b) careful procedural planning; and (c) contrast and radiation exposure minimisation. Use of drug-eluting stents is recommended for CTO PCI, given the lower rates of angiographic restenosis compared to bare metal stents.

Original languageEnglish (US)
Pages (from-to)195-200
Number of pages6
JournalInterventional Cardiology Review
Volume9
Issue number3
DOIs
Publication statusPublished - 2014

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Keywords

  • Chronic total occlusions
  • Outcomes
  • Percutaneous coronary intervention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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