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: dr s venkatesan Tags: acute coroanry syndrome cto chronic total occlusion open artery hypothesis ato vs cto management stemi Source Type: blogs
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