The Challenges of Chronic Total Coronary Occlusions: An Old Problem in a New Perspective

Author: KANDZARI, DAVID E.

Source: Journal of Interventional Cardiology, Volume 17, Number 4, August 2004 , pp. 259-267(9)

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Abstract:

In spite of the remarkable technological innovation and improved outcomes with percutaneous coronary revascularization, chronic coronary artery total occlusions remain a familiar source of procedural frustration and clinical uncertainty. However, considering the recent development of catheter-based technologies specific for chronic total occlusion (CTO) recanalization and the potential for drug-eluting stents to reduce restenosis and reocclusion, this challenging lesion subset is now recognized as the last formidable barrier to percutaneous revascularization success. Further, consistent observations from more recent clinical trials support successful CTO revascularization to avoid subsequent adverse cardiac events and improve long-term overall survival. This review of total coronary occlusions provides an overview of CTO pathophysiology, describes the procedural and clinical outcomes associated with CTO revascularization, and presents future directions for clinical investigation.

(J Interven Cardiol 2004;17:259-267)

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1540-8183.2004.04029.x

Publication date: 2004-08-01