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Chronic total occlusion percutaneous coronary interventions: identifying patients at risk of complications

Saroj Neupane1, Ankur Gupta2, Mir Basir2

  • 1Department of Internal Medicine, WakeMed Hospital , Raleigh, NC, USA.

Expert Review of Cardiovascular Therapy
|April 30, 2020
PubMed

Insights

Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is complex and carries higher risks. Identifying high-risk patients is crucial for shared decision-making and improving outcomes in CTO PCI procedures.

Area of Science:

  • Interventional Cardiology
  • Cardiovascular Medicine
  • Medical Risk Assessment

Background:

  • Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is indicated for refractory angina and complete revascularization post-acute coronary syndrome or in ischemic cardiomyopathy.
  • CTO PCI procedures are associated with a higher complication rate compared to non-CTO PCI.

Purpose of the Study:

  • To review risk prediction studies for CTO PCI.
  • To outline strategies for complication avoidance in CTO PCI.

Main Methods:

  • Literature review of available studies on risk prediction in CTO PCI.
  • Synthesis of strategies to mitigate complications during CTO PCI.

Main Results:

  • Risk stratification is essential for identifying patients at increased risk of periprocedural major adverse cardiovascular events (MACE).

Conclusions:

  • Identifying high-risk patients for CTO PCI enhances risk-benefit discussions.
  • Facilitates shared decision-making regarding the appropriateness of CTO PCI procedures.
Abstract

Keywords:
Chronic total occlusionPCI Complicationshigh risk PCImajor Adverse Cardiovascular Eventspercutaneous Coronary Intervention

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