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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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Coronary intervention for chronic total occlusion: current indications and future directions
Janarthanan Sathananthan1, Vladimír Džavík
1Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada.
Coronary Artery Disease
|July 11, 2017
Summary
Percutaneous coronary intervention for chronic total occlusions (CTOs) is now successful for most patients. This review examines the evolving evidence and future directions for CTO intervention.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- Chronic total occlusions (CTOs) are common findings in coronary angiography.
- Historically, revascularization rates for CTOs have been low due to perceived low clinical benefit and success rates of percutaneous coronary intervention (PCI).
Purpose of the Study:
- To review the current evidence supporting the clinical benefit and outcomes of CTO-PCI.
- To discuss the evolving indications and future directions for CTO intervention.
Main Methods:
- Review of predominantly nonrandomized studies on short-term and long-term outcomes of CTO-PCI.
- Discussion of recent and upcoming randomized-controlled trials.
Main Results:
- Experienced operators can now achieve high success rates with CTO-PCI using modern techniques and tools.
- A growing body of evidence suggests clinical benefit, though indications remain debated.
Conclusions:
- CTO-PCI is feasible and successful in the majority of patients.
- Further randomized trials are expected to clarify indications and expand the role of CTO-PCI in both stable patients and those with acute coronary syndromes.
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