Percutaneous Coronary Intervention in Elderly Patients with Coronary Chronic Total Occlusions: Current Evidence and Future Perspectives

The proportion of the elderly in the total population of the world is growing, and the number of elderly patients with coronary chronic total occlusions (CTO) is huge. The elderly patients often have more extensive coronary artery disease, more severe ischemic burden and higher risk of cardiovascula...

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Bibliographic Details
Published in:Clinical interventions in aging 2020-01, Vol.15, p.771-781
Main Authors: Guo, Lei, Lv, Hai-Chen, Huang, Rong-Chong
Format: Article
Language:English
Subjects:
Age
Aged
Angina pectoris
Angioplasty
Balloon angioplasty
Calcification
Cardiac patients
Cardiology
Cardiovascular disease
Clinical Decision-Making
Coronary artery bypass
coronary chronic total occlusions
Coronary Disease - diagnosis
Coronary Disease - surgery
Coronary heart disease
Coronary vessels
Diseases
Elderly
Elderly patients
Frailty
Gerontology
Heart attacks
Heart failure
Humans
Intervention
Medical imaging
Medical prognosis
Mortality
Older people
Patient Selection
percutaneous coronary intervention
Percutaneous Coronary Intervention - adverse effects
Percutaneous Coronary Intervention - methods
Review
Risk Adjustment
Severity of Illness Index
Success
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Summary:The proportion of the elderly in the total population of the world is growing, and the number of elderly patients with coronary chronic total occlusions (CTO) is huge. The elderly patients often have more extensive coronary artery disease, more severe ischemic burden and higher risk of cardiovascular events, as compared to younger patients, and thereby they might greatly benefit from coronary revascularization, even though they may have higher risk of operative complications. Most interventional cardiologists are more likely to be reluctant to operate complex percutaneous coronary intervention (PCI) in elderly patients. The latest refinements in dedicated CTO-PCI equipment and techniques have led to high rates of success and low complications rates and have made the CTO-PCI procedures safe and effective among the elderly patients. However, up to now, there is no widely recognized consensus or guideline on treatment strategy of elderly CTO patients, and the prognosis in this population is unknown. In this review, we aim to provide an overview of the current evidence and future perspectives on PCI in elderly patients with CTOs.
ISSN:1178-1998
1176-9092
1178-1998
DOI:10.2147/CIA.S252318