If CTO is safe , should we allow all PCI ineligible ATO to evolve as CTO ?

Hot debate in STEMI Acute total obstruction (ATO) of coronary artery is an emergency .Opening it  by pharmacological or catheter is the  standard ( logical ) protocol.However, time plays a crucial role in this coronary re-perfusion game.It can either be a sure shot of success or end up in total spoilsport. One more issue as important as time is from the overflowing scientific data  fired  by different regulators  in conflicting directions  (Also called knowledge) . What to do with STEMI coming late ? ATO with cardiogenic shock is an  absolute emergency at any time. Symptomatic ATO  other than CS beyond 24 hrs still  considered  emergency for most.(Symptom should be true angina ) Hemodynamic instability is misunderstood term . Stabilizing it medically is not forbidden as some modern cardiologist would suggest. Asymptomatic stable ATO  beyond  24-72 hours can be  semi emergency, true emergency or as cool  as a cucumber dependent on the cardiologist wisdom , experiences or inexperience  and the  Institutional Integrity ! *Please be reminded ,LV dysfunction is not an absolute indication for urgent intervention unless it is due to ischemic dysfunction attributable  to a critical non IRA lesion When does a ATO become safe CTO ? 1 month , 3 months, 6 months ? Why we are  not defining a sub-acute ATO ? or CTO in transition   ? Is living peacefully with sub acute ATO or CTO a coronary crime ? We don’t require a debate , whether these  questions are worth an...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: acute coroanry syndrome cto chronic total occlusion open artery hypothesis ato vs cto management stemi Source Type: blogs