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  • Editorial: Ischemic Cardiomyopathy and Chronic Total Coronary Occlusion: Could There Be a Benefit From Revascularization?

    The question of whether a chronically occluded coronary artery (chronic total occlusion [CTO]) should be revascularized in the presence of an often-extensive network of collaterals is still heavily disputed in the concept of treatment of coronary artery disease (CAD) if we look at the recommendations in the latest guidelines  . But if we accept that the treatment of disease has not only the goal of extending lifetime,i.e., prognosis, but first and foremost should alleviate symptoms and improve the quality of life, then there are ample arguments that opening a CTO effective removes limiting symptoms without the need of lifelong and less effective antianginal therapy. It is always puzzling to an interventional cardiologist why antianginal medications should be considered a gold standard of therapy, as these drugs do not alter prognosis at all but bring along a multitude and combination of side effects.

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