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. +18.104.22.1683 – Fax: +22.214.171.1247. E-mail: firstname.lastname@example.org
Share this Article
Related Content In Interventional Cardiology
Management of Atrial Fibrillation in Recipients of Cardiac Resynchronization Therapy
European Journal of Arrhythmia & Electrophysiology. 2021;7(1):19-25 DOI: https://doi.org/10.17925/EJAE.2021.7.1.19
Atrial fibrillation (AF) and heart failure (HF) often co-exist. The incidence of AF is estimated to reach 45% of patients with HF and rises with the severity of HF symptoms, from about 5% of patients in the New York Heart Association (NYHA) class I to 50% in NYHA class IV.1–4 Consistently, the incidence of AF […]
The ACURATE neo™ and neo2™ Valve Systems
Heart International. 2021;15(1):37-41 DOI: https://doi.org/10.17925/HI.2021.15.1.37
Transcatheter aortic valve replacement (TAVR) has seen worldwide explosive growth. The current USA guidelines no longer use risk in choosing between TAVR and surgical aortic valve replacement, and the European guidelines have extended the recommendation for TAVR to lower risk groups.1,2 This rapid expansion has been driven by data from randomized trials showing TAVR as […]
Foreword – Heart International. 2020;14(2):66
Welcome to the latest edition of Heart International. I would like to begin by paying tribute to all the victims of the coronavirus pandemic. I know of very few people who have not lost a family member, friend, colleague or a neighbour with COVID-19. Such deaths are not simply statistics, for behind each death is a […]
Journal articles and more to your inbox
Get the latest clinical insights from touchCARDIOSign me up!