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A Test in Context: E/A and E/e' to Assess Diastolic Dysfunction and LV Filling Pressure Geometry as a Confounder When Assessing Ventricular Systolic Function: Comparison Between Ejection Fraction and Strain Long-Term Outcomes in Women and Men Following Percutaneous Coronary Intervention Basic Biology of Oxidative Stress and the Cardiovascular System: Part 1 of a 3-Part Series A Combination of Allogeneic Stem Cells Promotes Cardiac Regeneration Heart Failure With Preserved, Borderline, and Reduced Ejection Fraction: 5-Year Outcomes Pulmonary Artery Pressure-Guided Management of Patients With Heart Failure and Reduced Ejection Fraction Association Between Living in Food Deserts and Cardiovascular Risk 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure Burden of 30-Day Readmissions After Percutaneous Coronary Intervention in 833,344 Patients in the United States: Predictors, Causes, and Cost
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Review Article2018 Jan 12;7(2).

JOURNAL：J Am Heart Assoc. Article Link

Chronic Total Occlusion Percutaneous Coronary Intervention: Evidence and Controversies

Tajti P, Brilakis ES. Keywords: chronic total occlusion; complex coronary intervention; percutaneous coronary intervention; stable coronary artery disease

ABSTRACT

Coronary chronic total occlusions (CTOs) are defined as 100% occlusions with TIMI (Thrombolysis in Myocardial Infarction) 0 flow with at least a 3‐month duration. Treatment options for patients with coronary CTOs include lifestyle changes and medications (as is appropriate for all patients with coronary artery disease) and coronary revascularization with either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). In the previous version of the appropriateness use criteria for coronary revascularization, revascularization recommendations were different for patients with and without a coronary CTO, but this is no longer the case in the current (2016 and 2017) versions.


The goal of this review is to summarize the available evidence on the clinical benefits, likelihood of success, risk for complications, and crossing strategies for CTO PCI and provide practical clinical recommendations.
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