Journal Article

Percutaneous treatment of chronic total occlusions: state of the art and future perspectives

Gagnor, Andrea, Colombo, Francesco, Garbo, Roberto

2015

Overview

Coronary chronic total occlusions (CTO) are a frequent finding in patients undergoing coronary angiography. However, a low percentage of patients is still referred for percutaneous coronary intervention. The main reasons lie in the skepticism concerning the real benefit and high technical complexity of these interventions. In recent years, thanks to the growing operators' experience and the introduction of new techniques and materials, the procedural success has increased with relatively low complication rates. There is growing evidence in recent literature that percutaneous recanalization improves symptoms and quality of life, increases ejection fraction and prolongs survival. Appropriate patient selection alone may involve a real clinical benefit in case of percutaneous CTO treatment. The key to procedural success is to use the right method and the knowledge of dedicated techniques and devices: CTO recanalization should be performed by experienced operators, and non-CTO interventionalists should approach these procedures only after specific training.

• Subject: Coronary Angiography - methods / Coronary Occlusion - therapy / Humans / Patient Selection / Percutaneous Coronary Intervention - methods / Quality of Life