Percutaneous Coronary Intervention of Chronic Total Occlusions: When and How to Treat
Highlights
- • CTOs have a detrimental effect on patients' quality of life and long-term prognosis.
- • Patient selection for CTO PCI should be focused on anticipated clinical benefit.
- • Indication for CTO PCI depends on the presence of symptoms, ischemia and viability.
- • The hybrid approach has led to technical success rates over 90% in CTO PCI.
- • The hybrid approach has led to acceptable complication rates in complex CTO PCI.
Abstract
Chronic coronary total occlusions (CTO) are diagnosed in up to 20% of patients with coronary artery disease and have a detrimental effect on patients' quality of life and long-term prognosis. The exponential developments in CTO percutaneous coronary intervention (PCI) equipment, recanalization techniques, and operator expertise have been merged into the hybrid approach that represents a percutaneous revascularization algorithm for treating CTOs and has led to technical success over 90% at experienced centers. Therefore, patient selection for CTO PCI should be focused on anticipated patient benefit in terms of health status and long-term prognosis rather than coronary anatomic complexity.