Related Experiment Video

Updated: May 24, 2026

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
09:12

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery

Published on: March 27, 2018

An update on coronary artery chronic total occlusions

Kimberly Brayton1, Atif Mohammad, Emmanouil S Brilakis

  • 1University of Texas Southwestern Medical Center, Dallas, TX 75216, USA.

Hospital Practice (1995)
|March 13, 2012
PubMed

Insights

Chronic total occlusions (CTOs) are common in coronary arteries. While revascularization techniques have improved, the clinical benefit of CTO revascularization remains uncertain due to limited evidence.

Area of Science:

  • Interventional Cardiology
  • Cardiovascular Medicine

Background:

  • Coronary artery chronic total occlusions (CTOs) are prevalent, affecting about one-third of patients undergoing coronary angiography.
  • CTO revascularization presents significant technical challenges, historically linked to lower success and higher complication rates.

Purpose of the Study:

  • To review the current status and challenges of coronary artery chronic total occlusion revascularization.
  • To highlight advancements in interventional cardiology for CTO treatment.
  • To address the ongoing dilemma regarding the clinical utility of CTO revascularization.

Main Methods:

  • Review of recent advancements in interventional cardiology techniques for CTO revascularization.
  • Analysis of historical procedural success and complication rates.
  • Evaluation of the existing clinical evidence supporting CTO revascularization.

Main Results:

  • Significant improvements in technical success rates for CTO revascularization over the past three decades.
  • Persistent challenges in achieving high procedural success and managing complications.
  • Lack of robust clinical evidence to definitively support routine CTO revascularization.

Conclusions:

  • Despite technical advancements, the decision-making process for CTO revascularization remains complex.
  • Further high-quality clinical trials are needed to establish the definitive role of CTO revascularization in patient management.
  • The clinical benefit of revascularizing coronary artery chronic total occlusions requires more robust evidence.

More Related Videos

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)13:10

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)

Published on: April 24, 2017

Related Concept Videos

Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
Coronary Artery Disease III: Clinical Manifestations01:30

Coronary Artery Disease III: Clinical Manifestations

Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...