A chronic total occlusion (CTO) is considered a special coronary lesion subset for which special considerations are applied regarding the indication for revascularization and the qualification of the operator. The complexity of advanced techniques for CTO treatment carry an imminent risk of specific complications such as periprocedural myocardial enzyme leaks, higher rate of side-branch occlusions, and perforation and pericardial tamponade. Long procedures with high contrast load may lead to contrast-induced nephropathy and radiation-induced skin alterations.
Due to the complexity of the required techniques and the requirement of special operator's skill set, CTOs seem to be undertreated, despite the evidence that is accumulating in support of the benefit of revascularization. Therefore, CTO PCI represents only a minority of interventional procedures undertaken, and it is all the more important to ensure the safety of these procedures and establish the long-term benefit but also the long-term complication rate.
View full article: https://doi.org/10.1016/j.carrev.2020.06.007