Review

. 2018 Apr 9;11(7):615-625.

doi: 10.1016/j.jcin.2017.10.052. Epub 2018 Mar 14.

Update in the Percutaneous Management of Coronary Chronic Total Occlusions

Peter Tajti¹, M Nicholas Burke², Dimitri Karmpaliotis³, Khaldoon Alaswad⁴, Gerald S Werner⁵, Lorenzo Azzalini⁶, Mauro Carlino⁶, Mitul Patel⁷, Kambis Mashayekhi⁸, Mohaned Egred⁹, Oleg Krestyaninov¹⁰, Dmitrii Khelimskii¹⁰, William J Nicholson¹¹, Imre Ungi¹², Alfredo R Galassi¹³, Subhash Banerjee¹⁴, Emmanouil S Brilakis¹⁵

Affiliations

¹ Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota; Division of Invasive Cardiology, University of Szeged, Second Department of Internal Medicine and Cardiology Center, Szeged, Hungary.
² Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota.
³ Department of Cardiology, Columbia University, New York, New York.
⁴ Department of Cardiology, Henry Ford Hospital, Detroit, Michigan.
⁵ Medizinische Klinik I (Cardiology and Intensive Care), Klinikum Darmstadt GmbH, Darmstadt, Germany.
⁶ Division of Interventional Cardiology, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy.
⁷ Department of Cardiology, UC San Diego Sulpizio Cardiovascular Center and VA San Diego Healthcare System, La Jolla, California.
⁸ Division of Cardiology and Angiology II, University Heart Center Freiburg Bad Krozingen, Bad Krozingen, Germany.
⁹ Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom.
¹⁰ Meshalkin Siberian Federal Biomedical Research Center, Ministry of Health of Russian Federation, Novosibirsk, Russian Federation.
¹¹ Department of Cardiology, WellSpan York Hospital, York, Pennsylvania.
¹² Division of Invasive Cardiology, University of Szeged, Second Department of Internal Medicine and Cardiology Center, Szeged, Hungary.
¹³ Department of Medical Sciences and Pediatrics, Catheterization Laboratory and Cardiovascular Interventional Unit, Cannizzaro Hospital, University of Catania, Catania, Italy.
¹⁴ VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas.
¹⁵ Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota; VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas. Electronic address: esbrilakis@gmail.com.

PMID: 29550088
DOI: 10.1016/j.jcin.2017.10.052

Free article

Review

Update in the Percutaneous Management of Coronary Chronic Total Occlusions

Peter Tajti et al. JACC Cardiovasc Interv. 2018.

Free article

. 2018 Apr 9;11(7):615-625.

doi: 10.1016/j.jcin.2017.10.052. Epub 2018 Mar 14.

Authors

Affiliations

¹ Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota; Division of Invasive Cardiology, University of Szeged, Second Department of Internal Medicine and Cardiology Center, Szeged, Hungary.
² Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota.
³ Department of Cardiology, Columbia University, New York, New York.
⁴ Department of Cardiology, Henry Ford Hospital, Detroit, Michigan.
⁵ Medizinische Klinik I (Cardiology and Intensive Care), Klinikum Darmstadt GmbH, Darmstadt, Germany.
⁶ Division of Interventional Cardiology, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy.
⁷ Department of Cardiology, UC San Diego Sulpizio Cardiovascular Center and VA San Diego Healthcare System, La Jolla, California.
⁸ Division of Cardiology and Angiology II, University Heart Center Freiburg Bad Krozingen, Bad Krozingen, Germany.
⁹ Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom.
¹⁰ Meshalkin Siberian Federal Biomedical Research Center, Ministry of Health of Russian Federation, Novosibirsk, Russian Federation.
¹¹ Department of Cardiology, WellSpan York Hospital, York, Pennsylvania.
¹² Division of Invasive Cardiology, University of Szeged, Second Department of Internal Medicine and Cardiology Center, Szeged, Hungary.
¹³ Department of Medical Sciences and Pediatrics, Catheterization Laboratory and Cardiovascular Interventional Unit, Cannizzaro Hospital, University of Catania, Catania, Italy.
¹⁴ VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas.
¹⁵ Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota; VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas. Electronic address: esbrilakis@gmail.com.

PMID: 29550088
DOI: 10.1016/j.jcin.2017.10.052

Abstract

Percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs) has been rapidly evolving during recent years. With improvement in equipment and techniques, high success rates can be achieved at experienced centers, although overall success rates remain low. Prospective, randomized-controlled data regarding optimal use and indications for CTO PCI remain limited. CTO PCI should be performed when the anticipated benefit exceeds the potential risk. New high-quality studies of the clinical outcomes and techniques of CTO PCI are needed, as is the expansion of expert centers and operators that can achieve excellent clinical outcomes in this challenging patient and lesion subgroup. In the current review the authors summarize the latest publications in CTO PCI and provide an overview of the current state of the field.

Keywords: chronic total occlusion; percutaneous coronary intervention; stable coronary artery disease.

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Comment in

Strong Bias Toward Performing Percutaneous Coronary Intervention in Patients With Chronic Total Occlusion Despite Lack of Important Benefit at a Very High Cost and Risk to the Patient.
Movahed MR. Movahed MR. JACC Cardiovasc Interv. 2018 Aug 13;11(15):1540-1541. doi: 10.1016/j.jcin.2018.04.031. JACC Cardiovasc Interv. 2018. PMID: 30093063 No abstract available.
Reply: Strong Bias Toward Performing Percutaneous Coronary Intervention in Patients With Chronic Total Occlusion Despite Lack of Important Benefit at a Very High Cost and Risk to the Patient.
Tajti P, Burke MN, Karmpaliotis D, Alaswad K, Werner GS, Azzalini L, Carlino M, Patel M, Mashayekhi K, Egred M, Krestyaninov O, Khelimskii D, Nicholson WJ, Ungi I, Galassi AR, Banerjee S, Brilakis ES. Tajti P, et al. JACC Cardiovasc Interv. 2018 Aug 13;11(15):1541-1542. doi: 10.1016/j.jcin.2018.05.015. JACC Cardiovasc Interv. 2018. PMID: 30093064 No abstract available.

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Update in the Percutaneous Management of Coronary Chronic Total Occlusions

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Update in the Percutaneous Management of Coronary Chronic Total Occlusions

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