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Book

Chronic Coronary Occlusion

Moghniuddin Mohammed  1 , Moien AB Khan  2
In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.
.
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Free Books & Documents
Book

Chronic Coronary Occlusion

Moghniuddin Mohammed et al.
Free Books & Documents

Excerpt

Chronic coronary occlusion or chronic total occlusion (CTO) refers to complete luminal diameter stenosis with resultant thrombolysis in myocardial infarction (TIMI) grade flow 0 or 1. In such, there is no anterograde flow due to collaterals. The occlusion should be of at least three months' duration to be labeled as chronic. The main vessels that are affected due to CTO are the right coronary artery (43% to 55%), the left anterior descending artery (approximately 24%), and the left circumflex artery (17%-20%). Functional CTOs represent severe occlusion, but not a complete occlusion of the coronary arteries. Such functional CTOs have collateral circulations presenting as anterograde flow. However, even such collateral flow is unable to sustain future ischemic events in functional CTOs, indicating a need for revascularization.

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Conflict of interest statement

Disclosure: Moghniuddin Mohammed declares no relevant financial relationships with ineligible companies.

Disclosure: Moien AB Khan declares no relevant financial relationships with ineligible companies.

References

    1. Mannem S, Rattanawong P, Riangwiwat T, Vutthikraivit W, Putthapiban P, Sukhumthammarat W, Kanitsoraphan C, Chongsathidkiet P. Sex Difference and Outcome after Percutaneous Intervention in Patients with Chronic Total Occlusion: A Systematic Review and Meta-Analysis. Cardiovasc Revasc Med. 2020 Jan;21(1):25-31. - PubMed
    1. Fefer P, Knudtson ML, Cheema AN, Galbraith PD, Osherov AB, Yalonetsky S, Gannot S, Samuel M, Weisbrod M, Bierstone D, Sparkes JD, Wright GA, Strauss BH. Current perspectives on coronary chronic total occlusions: the Canadian Multicenter Chronic Total Occlusions Registry. J Am Coll Cardiol. 2012 Mar 13;59(11):991-7. - PubMed
    1. Stone GW, Kandzari DE, Mehran R, Colombo A, Schwartz RS, Bailey S, Moussa I, Teirstein PS, Dangas G, Baim DS, Selmon M, Strauss BH, Tamai H, Suzuki T, Mitsudo K, Katoh O, Cox DA, Hoye A, Mintz GS, Grube E, Cannon LA, Reifart NJ, Reisman M, Abizaid A, Moses JW, Leon MB, Serruys PW. Percutaneous recanalization of chronically occluded coronary arteries: a consensus document: part I. Circulation. 2005 Oct 11;112(15):2364-72. - PubMed
    1. Tsai TT, Stanislawski MA, Shunk KA, Armstrong EJ, Grunwald GK, Schob AH, Valle JA, Alfonso CE, Nallamothu BK, Ho PM, Rumsfeld JS, Brilakis ES. Contemporary Incidence, Management, and Long-Term Outcomes of Percutaneous Coronary Interventions for Chronic Coronary Artery Total Occlusions: Insights From the VA CART Program. JACC Cardiovasc Interv. 2017 May 08;10(9):866-875. - PubMed
    1. Tajti P, Karmpaliotis D, Alaswad K, Jaffer FA, Yeh RW, Patel M, Mahmud E, Choi JW, Burke MN, Doing AH, Dattilo P, Toma C, Smith AJC, Uretsky B, Holper E, Wyman RM, Kandzari DE, Garcia S, Krestyaninov O, Khelimskii D, Koutouzis M, Tsiafoutis I, Moses JW, Lembo NJ, Parikh M, Kirtane AJ, Ali ZA, Doshi D, Rangan BV, Ungi I, Banerjee S, Brilakis ES. The Hybrid Approach to Chronic Total Occlusion Percutaneous Coronary Intervention: Update From the PROGRESS CTO Registry. JACC Cardiovasc Interv. 2018 Jul 23;11(14):1325-1335. - PubMed

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