Chronic total occlusion (CTO) angioplasty is
one of the most challenging procedures
remaining for the interventional operator.
Recanalizing CTOs can improve exercise
capacity, symptoms, left ventricular function
and possibly reduce mortality. Multiple strategies
such as escalating wire, parallel wire, seesaw,
contralateral injection, subintimal tracking
and re-entry (STAR), retrograde wire techniques
(controlled antegrade retrograde subintimal
tracking, CART), reverse CART, confluent
balloon, rendezvous in coronary, and other
techniques have all been described. Selection
of the most appropriate approach is based on
assessment of vessel course, length of occluded
segment, presence of bridging collaterals, presence
of bifurcating side branches at the occlusion
site, and other variables. Today, with significant
operator expertise and the use of available
techniques, the literature reports a 50-95%
success rate for recanalizing CTOs.
Percutaneous coronary intervention, chronic total occlusion.
Farrukh Hussain, Cardiac Catheterization Lab., St. Boniface General Hospital, University of Manitoba, Canada. Tel. +1.204.237.2023 – Fax: +1.204.233.2157. E-mail: fhussain@sbgh.mb.ca
2011-12-05T00:00:00
Trending Topic
We are sorry to announce the death of one of our valued editorial board members, Dr Richard Heuser (November 17, 1950–May 23, 2024). Richard R Heuser, MD, FACC, FACP, FESC, MSCAI, was an internationally recognized cardiologist, inventor, educator and author, and was a diplomat of the American Board of Cardiovascular Diseases and the American Board […]
Welcome to the summer issue of Heart International. We are excited to present a collection of insightful articles that delve into various aspects of cardiovascular health and related interventions. This issue encompasses a wide array of topics, from novel treatment ...
Clinically relevant tricuspid regurgitation (TR) is a common disorder, affecting approximately 4% of people 75 years of age or older.1 If left untreated, severe TR results in volume overload and right ventricular remodelling. This eventually leads to symptomatic right-sided heart failure, along ...
In this issue of Heart International, we are delighted to present a collection of insightful articles that encompass a wide spectrum of topics within the field of cardiovascular medicine. As we navigate the landscape of cardiovascular disease, heart failure, preventative ...
For decades, right ventricular pacing (RVP) has been the leading pacing technique and has been proven to be effective in treating patients with symptomatic bradycardia. However, dyssynchrony caused by non-physiological ventricular activation results in pacing-induced cardiomyopathy occurs in approximately 15% of ...
Welcome to the latest issue of Heart International. This edition includes a range of articles on topics showcasing the latest advances in our understanding and treatment of cardiovascular disease. We begin with focus on the hereditary cardiac disorder, hypertrophic cardiomyopathy, ...
A significant proportion of patients with atrial fibrillation (AF) who have a high stroke risk are currently being treated with oral anticoagulation (OAC), including direct oral anticoagulants (DOACs) and vitamin K inhibitors (VKAs).1 It is well known that the increased ...
The American Diabetes Association (ADA) defines prediabetes as glycated haemoglobin (HbA1c) 5.7–6.4% or fasting plasma glucose (FPG) 100–125 mg/dL or 5.6–6.9 mmol/L.1 Patients with prediabetes have up to a 70% chance of developing diabetes and a two-fold higher risk of cardiovascular ...
Welcome to the latest issue of Heart International. Cardiovascular science continues to evolve at an impressive rate, and the range of articles presented here highlights cutting-edge technology and innovation within cardiology. We begin with a commentary by Divaka Perera on ...
Welcome to the latest issue of Heart International. We are delighted to bring you another excellent issue, full of the varied and expert articles that you can expect from our authors. We begin with some exciting news. We are delighted ...
Welcome to the latest issue of Heart International. The global coronavirus disease 2019 (COVID-19) pandemic has presented numerous challenges that have altered all areas of health care, including cardiology. Despite these challenges, the past year has shown significant innovation across the ...
Available evidence from randomized studies suggests that most bifurcation lesions are best managed with a provisional stenting (PS) approach, as this is associated with fewer complications, simpler procedures and better outcomes, compared with elective double stenting.1–6 However, the Achilles’ heel ...
The first coronary stent was implanted by Sigwart and Puel in 1986.1 Coronary stents were initially used to treat failure of balloon angioplasty treatment, i.e. as bail-out for acute vessel closure (due to dissections) or restenosis (due to elastic recoil). ...
Explore the latest in medical education and stay current in your field. Create a free account to track your learning.