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Updated: Jul 16, 2026
Permanent Cerebral Vessel Occlusion via Double Ligature and Transection
Published on: July 21, 2013
[Is always chronic total occlusion indication for recanalization in patients with multi-vessel disease]
Insights
Recanalizing chronic total occlusions (CTOs) in patients with myocardial infarction improves heart muscle function, even with other blocked arteries. This study suggests CTOs should be treated with angioplasty to restore blood flow.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Imaging
Context:
- Chronic total occlusions (CTOs) remain a challenge in interventional cardiology.
- Assessing myocardial viability in CTOs is crucial for treatment decisions.
- The impact of CTO recanalization on myocardial contractility, especially with multi-vessel disease, requires further investigation.
Purpose:
- To evaluate the effect of CTO recanalization on global and regional myocardial contractility in patients with myocardial infarction (MI).
- To test the hypothesis that CTO recanalization improves myocardial function in the presence of other stenotic coronary arteries.
Summary:
- 120 patients with MI underwent stress echocardiography to assess myocardial viability.
- Patients were divided into complete revascularization and CTO-only revascularization groups.
- Restoration of antegrade flow in CTOs in multi-vessel disease patients led to a decrease in coronary artery disease attacks and heart failure symptoms.
Impact:
- CTO recanalization can improve myocardial contractility and reduce symptoms of heart failure and coronary artery disease.
- The findings support considering CTOs as an indication for angioplasty, particularly in patients with multi-vessel disease.
- This research contributes to optimizing revascularization strategies for patients with complex coronary artery disease.
Abstract:
The issue of recanalization chronic total occlusion (CTO) up today stays unsolved. Existence of viable myocardium in the CTO basin is regarded to be one of the proofs in cases of transitory ischemia or in the state of hibernation. But, the question of CTO opening in presence of acinetic segments is still under discussion. The aim of our study is testing assumption that CTO recanalization in the presence of other stenotic arteries, improves global and regional contractility of myocardium. One hundred and twenty patients with MI after one month were enrolled. To diagnose viability of myocardium 72% of patients went through stress-echocardiography with small dozes of dobutimin. After, all patients were divided into two groups: who have to undergo complete revascularization (Group I- 35,5%), and those who have to undergo only CTO revascularization (Group II- 64,5%). There were no significant statistic differences in hemodynamic parameters between groups. In case of multi-vessel disease restoration of antegrade flow in CTO caused to block of CAD attacks and symptoms of congestive heart failure. Therefore, results of the study let us state existence of CTO as indication for angioplasty of infarct-related artery.
