[Percutaneous coronary intervention for chronic total occlusion: clinical perspectives in 2015]

Abstract

Chronic total occlusions (CTOs) are considered as the last frontier of percutaneous coronary intervention (PCI). Despite an incidence of 15-30%, CTOs are largely undertreated (< 10%) by percutaneous techniques, as the majority of patients are managed conservatively or surgically. Although data from randomized trials are lacking, current evidence suggests that successful CTO-PCI improves symptoms, quality of life and long-term survival. CTO-PCI represents the most technically challenging procedure in contemporary interventional cardiology. Recent interventional developments and increasing experience of dedicated operators have significantly improved procedural success rates up to 90%. This review aims to provide a contemporary overview on the current body of evidence regarding CTO-PCI, with an emphasis on the clinical benefits and patient selection criteria.