Update on chronic total occlusion percutaneous coronary intervention

Prog Cardiovasc Dis. 2021 Nov-Dec:69:27-34. doi: 10.1016/j.pcad.2021.11.004. Epub 2021 Nov 23.

Abstract

Chronic total occlusion (CTO) percutaneous coronary interventions (PCI) can be challenging to perform. The main indication for CTO PCI is to improve symptoms. Several contemporary studies have reported high CTO PCI success rates at experienced centers but success rates in all-comer registries remain low. Several scores can estimate the difficulty and the likelihood of success of CTO PCI. Dual arterial access and use of CTO crossing algorithms can improve the success and safety of CTO PCI. Intracoronary imaging can optimize stent expansion and minimize adverse cardiovascular events. While complications are more common in CTO PCI, careful planning and prompt diagnosis and treatment can prevent them or minimize their adverse consequences. In this article, we review contemporary data on the indications, safety and efficacy of CTO PCI.

Keywords: Chronic total occlusion; Complications; Outcomes; Percutaneous coronary interventions; Techniques.

Publication types

  • Review

MeSH terms

  • Chronic Disease
  • Coronary Angiography / methods
  • Coronary Occlusion* / diagnostic imaging
  • Coronary Occlusion* / surgery
  • Humans
  • Percutaneous Coronary Intervention* / adverse effects
  • Percutaneous Coronary Intervention* / methods
  • Registries
  • Risk Factors
  • Treatment Outcome