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Solving Challenging Situations and Complications in Everyday Percutaneous Coronary Intervention Using Chronic Total
Lorenzo Azzalini1, Georgios Tzanis, Kambis Mashayekhi
1Interventional Cardiology Division, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy. azzalini.lorenzo@hsr.it.
Abstract:
The field of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has witnessed a dramatic evolution in the last decade. The challenging nature of CTO interventions involves regularly dealing with support-related issues, uncrossable/undilatable lesions, manipulation of equipment in the subadventitial (also known as "subintimal") space, and the treatment of complications such as perforation and equipment loss or entrapment. The CTO experience has provided numerous techniques to the creative operator facing challenges in the non-CTO PCI setting. Herewith, we discuss an armamentarium of techniques routinely used in CTO-PCI, which can also be utilized in interventions for non-occlusive coronary artery disease and have the potential to improve the efficacy and safety of these procedures.
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