Percutaneous coronary interventions of chronic total -occlusions; a review of clinical indications, treatment strategy and current practice.

Percutaneous coronary interventions of chronic total -occlusions; a review of clinical indications, treatment strategy and current practice. Acta Cardiol. 2017 Jul 14;:1-13 Authors: Bennett J, Kayaert P, Bataille Y, Dens J Abstract Chronic total occlusions (CTOs) are commonly encountered in patients undergoing coronary angiography, but percutaneous coronary intervention (PCI) for CTO is currently infrequently performed owing to the perception of limited clinical benefit, high complexity and cost of intervention, and perceived risk of complications. Numerous observational studies have demonstrated that successful CTO revascularization is associated with better cardiovascular outcomes and enhanced quality of life (QOL). However, in the absence of randomized trials, its prognostic benefit remains debated. Nevertheless, over the past decade the interest in CTO-PCI has exponentially grown due to important developments in dedicated equipment and techniques, resulting in high success and low complication rates. A number of factors must be taken into consideration in selecting patients for CTO-PCI, including presence of symptoms attributable to the CTO, extent of ischaemia distal to the occlusion, and degree of myocardial viability. In this review, we focus on the impact of CTO revascularization on clinical outcomes and QOL and on appropriate patient selection. Data regarding efficacy and safety of recent advances in PCI-CTO techniques will ...
Source: Acta Cardiologica - Category: Cardiology Tags: Acta Cardiol Source Type: research