Drug eluting stent and coronary chronic total occlusions

Chronic total occlusion (CTO) is a common finding on diagnostic coronary angiography and represents one of the most challenging lesion subset in interventional cardiology. The introduction of dedicated guidewires and the development of new techniques have led to improve the success rate in the crossing of CTO lesion while the use of bare metal stent first, and, then, the use of drug eluting stent (DES) have significantly reduced the occurrence of restenosis and the need for target lesion revascularization in short and mid-term follow-up after CTO recanalization. However, new unsolved issues about the use of DES in CTO, that might impact long-term outcome, are emerging. The aim of this article is to review the current stage of knowledge on the application of stents in the treatment of CTO, with a particular attention to DES use and to DES-related challenges.