Recanalization of Chronic Total Occlusion Lesions: A Critical Appraisal of Current Devices and Techniques

Abstract

Chronic Total Occlusion (CTO) has been considered as one of the "final frontier" in interventional cardiology. Until recently, the patients with CTO are often managed surgically or medically due to lack of published evidence of clinical benefits and lower success rate of percutaneous recanalization of CTO. However, the introduction of enhanced guidewires, microcatheters combined with novel specialized devices and techniques reduce the number of unapproachable CTO. In this review article, current techniques and devices of percutaneous recanalization of CTO have been systematically summarized, which may help budding interventional cardiologists to theoretically understand these complex procedures and to deliver safe and effective percutaneous management of CTO to the patients.

Keywords: Guidewires; Microcatheters; Percutaneous coronary intervention.

[Table/Fig-1]:

Finecross microcatheter.

[Table/Fig-2]:

Tornus microcatheter.

[Table/Fig-3]:

Corsair microcatheter.

[Table/Fig-4]:

Parallel-wire technique.

[Table/Fig-5]:

Microchannel technique.

[Table/Fig-6]:

STAR technique.

[Table/Fig-7]:

Just-marker technique.

[Table/Fig-8]:

Kissing wire technique.

[Table/Fig-9]:

CART technique.

[Table/Fig-10]:

Reverse-CART technique.

[Table/Fig-11]:

Knuckle wire technique.