Chronic Total Occlusions: A State-of-the-Art Review

The percutaneous management of chronic total occlusions (CTO) is a well-established sub-specialty of Interventional Cardiology, requiring specialist equipment, training, and techniques. The heterogeneity of approaches in CTO has led to the generation of multiple algorithms to guide operators in thei...

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Bibliographic Details
Published in:Heart, lung & circulation lung & circulation, 2024-06, Vol.33 (6), p.764-772
Main Authors: O’Brien, Joseph M., Dautov, Rustem, Sapontis, James
Format: Article
Language:English
Subjects:
Chronic Disease
Chronic total occlusion
Coronary Occlusion - diagnosis
Coronary Occlusion - surgery
Coronary Occlusion - therapy
CTO
Humans
PCI
Percutaneous coronary intervention
Percutaneous Coronary Intervention - methods
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Summary:The percutaneous management of chronic total occlusions (CTO) is a well-established sub-specialty of Interventional Cardiology, requiring specialist equipment, training, and techniques. The heterogeneity of approaches in CTO has led to the generation of multiple algorithms to guide operators in their management. The evidence base for management of CTOs has suffered from inconsistent descriptive and quantitative terminology in defining the nature of lesions and techniques utilised, as well as seemingly contradictory data about improvement in ventricular function, symptoms of angina, and mortality from large-scale registries and randomised controlled trials. Through this review, we explore the history of CTO management and its supporting evidence in detail, with an outline of limitations of CTO-percutaneous coronary intervention and a look at the future of this growing field within cardiology.
ISSN:1443-9506
1444-2892
1444-2892
DOI:10.1016/j.hlc.2024.01.031