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Related Experiment Video

Updated: Apr 19, 2026

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Two-vessel chronic total occlusion. Complete percutaneous revascularisation.

Artur Dębski1, Paweł Tyczyński1, Maksymilian P Opolski1

  • 1Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw, Poland.

Postepy W Kardiologii Interwencyjnej = Advances in Interventional Cardiology
|December 10, 2014
PubMed
Summary

This case study shows that a second attempt can successfully open chronic total occlusions, even in challenging two-vessel cases. Experienced interventionists can achieve complete percutaneous revascularization after an initial failed procedure.

Keywords:
multiple chronic total occlusionpercutaneous coronary intervention

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Area of Science:

  • Interventional Cardiology
  • Cardiovascular Medicine
  • Percutaneous Coronary Intervention

Background:

  • Chronic total occlusions (CTO) pose significant challenges in percutaneous coronary intervention.
  • The success rate of repeat procedures for CTO, particularly in multi-vessel disease, is not well-established.
  • Percutaneous revascularization of CTOs requires substantial operator experience, especially after a prior failed attempt.

Purpose of the Study:

  • To present a case of successful percutaneous revascularization of two chronic total occlusions in a staged procedure.
  • To highlight the feasibility of a second attempt in complex CTO cases.
  • To underscore the importance of experience in managing challenging coronary lesions.

Main Methods:

  • A 52-year-old male patient with two chronic total occlusions underwent a staged percutaneous coronary intervention.
  • The procedure involved a second attempt at revascularization after a previous unsuccessful intervention.
  • Advanced interventional techniques were employed to achieve successful lesion crossing and stent deployment.

Main Results:

  • Successful percutaneous opening of both chronic total occlusions was achieved in a staged manner.
  • The second procedural attempt demonstrated efficacy in complex CTO revascularization.
  • Complete revascularization was attained, addressing the patient's multi-vessel coronary artery disease.

Conclusions:

  • Repeat percutaneous attempts can be successful for chronic total occlusions, even in complex scenarios.
  • Operator experience is crucial for managing challenging CTOs and achieving successful outcomes.
  • Staged procedures can be a viable strategy for complete revascularization in patients with multiple CTOs.