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Current Perspectives and Practices on Chronic Total Occlusion Percutaneous Coronary Interventions
Siddharth M Patel, Rohan V Menon, M Nicolas Burke
1Minneapolis Heart Institute, 920 E. 28th Street #300, Minneapolis, MN 55407 USA. esbrilakis@gmail.com.
The Journal of Invasive Cardiology
|October 17, 2017
Summary
Most cardiologists recognize the benefits of chronic total occlusion (CTO) percutaneous coronary intervention (PCI), viewing it as beneficial for patient symptoms and survival. Interventional cardiologists generally hold a more positive outlook on CTO-PCI outcomes and success rates.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiovascular Interventions
Background:
- The frequency and success rates of chronic total occlusion percutaneous coronary intervention (CTO-PCI) have been increasing.
- CTO-PCI is a complex procedure addressing significant coronary artery disease.
Purpose of the Study:
- To examine current perspectives and practices regarding CTO-PCI among cardiologists.
- To understand the perceived benefits, success rates, and barriers associated with CTO-PCI.
Main Methods:
- An online questionnaire was distributed to cardiologists globally.
- 1149 responses were collected, with a majority from the United States.
- Respondents included interventional and non-interventional cardiologists with varying years of practice.
Main Results:
- A high percentage of cardiologists believe CTO-PCI improves patient symptoms, left ventricular function, and survival.
- Interventional cardiologists reported more favorable views on CTO-PCI benefits and success rates compared to non-interventionalists.
- Procedural success was estimated between 51%-85% by most respondents, with perforation, mortality, and tamponade as key concerns.
Conclusions:
- Cardiologists widely acknowledge the clinical benefits of CTO-PCI, anticipating moderate to high success rates.
- A disparity exists in perception, with interventional cardiologists showing a more optimistic view of CTO-PCI compared to their non-interventional colleagues.
- Procedural time and complexity are identified as primary obstacles to establishing CTO-PCI programs.