What is the risk of ACS after PCI in a CTO related artery ?

CTOs are opened primarily for four reasons Angina which is refractory to drugs Stress test positivity with or without angina Anxiety of having a blocked coronary artery in a self educated patient Cardiologist’s clandestine pride & pursuit* * Personal experience included Some evidence based observation Most of the studies as on today do not give survival advantage of opening a CTO.(DECISION-CTO,EURO-CTO,EXPLORE,IMPACTOR) Opening a CTO, for reasons other than angina (i.e. for relief of dyspnea or improving functional capacity) is largely conjectural and based on randomly accrued data backed by poor interpretation. The role of collateral circulation in CTO that can compensate even during exercise is well known at patient level data. This has become a difficult area of research because it involves spending more time with the patient, and hence not studied much. We are in the era of artificial intelligence ,virtual patients and statistical extrapolations that can steer the Kaplan Meyer curves in the desired direction. Pure academicians shall follow the current guidelines. Surprise… surprise !, There is some good news. The normally aggressive American guidelines exercise much caution with a 2B punch. Still , even today it is weird to see hours of academic time is consumed in CTO Interventions in any interventional cardiology meets. (May be , they could get a breakthrough benefit , which I couldn’t appreciate) . CTO-PCI ...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: Uncategorized cto cto hardware cto trials jcto score open artery hypothesisacc esc aha guidelines Source Type: blogs