[Angioplasty in chronic coronary occlusion]

In the last few years, coronary angioplasty has been the object of real progress in the treatment of total chronic coronary occlusion; The primary success rate of the procedure regularly exceeds 70% with the use of improved equipment; however, these procedures are not without risk with a reported complication rate close to that of angioplasty of non-occlusive stenosis. The use of stents has significantly reduced the restenosis rate, mainly by decreasing the risk of reocclusion. The indications of angioplasty for chronic occlusion remain controversial: the procedure is justified in patients with angina; in asymptomatic patients, angioplasty may improve global and regional left ventricular function in those with documented myocardial viability and limit ventricular remodelling but the results of a randomised trial of systematic angioplasty versus medical treatment in this type of indication are not yet available.