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3 years ago
Coronary chronic total occlusions (CTOs) are identified in up to one third of patients with coronary artery disease referred for nonurgent coronary angiography,1,2 with an incidence increasing with age.3 Conceptually, you may argue that the motivation to reopen a totally blocked artery is not as strong as for subocclusive lesions, that have the potential to progress and cause acute events. The…
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3 years ago
Introduction and Objectives
A symposium, chaired by Dr Heinz Joachim Büttner of Freiburg-Bad Krozingen (Germany) and Dr Masahisa Yamane of St Luke’s International Hospital (Tokyo, Japan) took place at EuroPCR, Paris on May 23rd, 2014. Its objectives were as follows: to learn how to improve the success of percutaneous intervention (PCI) in chronic total occlusion (CTO) by matching techniques to…
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2 years ago
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3 years ago
Section A
Techniques for Chronic Total Occlusions Revascularisation
Access Route, Guiding Catheter Selection and Contralateral Injection
The femoral approach is the preferred access route by most operators. However, the radial approach might be chosen because of severe peripheral vascular disease, operator’s preference or for contralateral injection. The guiding principle of access selection is…
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3 years ago
Proceedings of two satellite symposia held at EuroPCR, Paris in May 2015
Although the latest polymeric drug-eluting stents (DES) have enhanced percutaneous coronary intervention (PCI) procedures, a substantial proportion of patients requiring percutaneous transluminal coronary angiography (PTCA) is elderly with numerous different comorbidities. This population requires use of effective DES that…
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3 years ago
Definition and Prevalence
Chronic coronary occlusions (CTOs) are defifined as lesions with Thrombolysis in Myocardial Infarction (TIMI) 0 flow older than three months (either angiographically proven or with high clinical likelihood). 1 According to a recent Canadian registry, CTOs are detected in about 30 % of patients with symptomatic coronary artery diseases (CAD).2 Likewise a very large German…
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2 years ago
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3 years ago
Multivessel coronary artery disease (MVCAD) is defined by the presence of ≥50% diameter stenosis of two or more epicardial coronary arteries. The presence of MVCAD indicates poorer prognosis and a significantly higher mortality than single-vessel disease. In MVCAD, revascularisation can be achieved by either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG).1,2 A…
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2 years ago
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3 years ago
There has been rapid development in the techniques used for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) over the past decade, with success rates in experienced centres now exceeding 90%.1 This is in part due to advances in devices and techniques for CTO crossing, but also an improved understanding of strategy. The development of the ‘hybrid algorithm’ has improved…
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