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Is it Worthy Enough to Revascularize Chronically Occluded Coronaries?
Ankit Kumar Sahu1, Danish Hasan Kazmi2, Atul Kaushik3
1From the Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, India.
Cardiology in Review
|March 13, 2023
Summary
Treating chronic total occlusions (CTOs) in coronary interventions remains challenging. While historically linked to survival benefits, recent trials show improved cardiac function and quality of life, not overall survival.
Area of Science:
- Interventional Cardiology
- Cardiovascular Medicine
- Vascular Biology
Background:
- Chronic total occlusions (CTOs) are complex coronary lesions frequently encountered during angiography.
- CTOs increase the complexity of coronary artery disease, influencing treatment decisions and often leading to coronary artery bypass graft surgery (CABG).
- Percutaneous coronary intervention (PCI) for CTOs has historically faced challenges with procedural success rates.
Conclusions:
- The role of CTO intervention is being redefined, focusing on specific patient groups with clear indications.
- While overall survival benefits are debated, CTO-PCI may offer advantages in cardiac function and patient well-being.
- Careful patient selection, including assessment of ischemia and viability, is crucial for optimizing the risk-benefit profile of CTO interventions.
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