Chronic total coronary occlusion recanalization: Current techniques and new devices - PubMed (original) (raw)
Review
Chronic total coronary occlusion recanalization: Current techniques and new devices
Jan-Erik Gülker et al. J Saudi Heart Assoc. 2017 Apr.
Abstract
Percutaneous coronary intervention (PCI) of total chronic coronary occlusion (CTO) still remains a major challenge. The prevalence of a CTO has been reported to be up to 30% among patients with a clinical indication for coronary angiography. Progress has been made with further advanced interventional techniques and continuously sophisticated interventional tools. Nevertheless the number of interventions carried out to recanalize a CTO is less than 10% of all procedures. Benefits of a successful CTO recanalization include relief of angina pectoris and ischemia-related dyspnea, substantial improvement in left ventricular function and, avoidance of surgery treatment. A vast variety of new CTO PCI techniques and materials has been introduced into clinical practise and pushed success rates of reopening a CTO up to around 90% in experienced hands. Particulary the introduction of the retrograde technique was a milestone. New developed microcatheters and special polymer coated wires allow to recanalize via small collaterals and vessels. Other tools such as intravascular ultrasound (IVUS) and multislice computertomography (MSCT) help to identify the anatomy and the characteristic of the lesions. Any invasive cardiac center should adopt CTO PCI procedures as standard therapy.
Objective: This review wants to assess and describe the latest development in CTO recanalization strategies.
Keywords: Chronic total occlusion; Coronary artery disease; Latest development; Recanalization strategies; Technical innovation.
Figures
Fig. 1
Parallel wire technique.
Fig. 2
Retrograde CTO crossing techniques: (A) retrograde wiring, (B) kissing wire technique, (C) reverse CART technique, and (D) CART technique . CART = controlled antegrade and retrograde tracking; CTO = chronic total coronary occlusion.
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References
- Di Mario C., Werner G.S., Sianos G., Galassi A.R., Büttner J., Dudek D. European perspective in the recanalisation of chronic total occlusions (CTO): consensus document from the EuroCTO Club. EuroIntervention. 2007;3:30–43. - PubMed
- Werner G.S., Gitt A.K., Zeymer U., Juenger C., Towae F., Wienbergen H. Chronic total coronary occlusions in patients with stable angina pectoris: impact on therapy and outcome in present day clinical practice. Clin Res Cardiol. 2009;98:435–441. - PubMed
- Abbott J.D., Kip K.E., Vlachos H.A., Sawhney N., Srinivas V.S., Jacobs A.K. Recent trends in the percutaneous treatment of chronic total coronary occlusions. Am J Cardiol. 2006;97:1691–1696. - PubMed
- Werner G.S. Therapie des chronischen Koronararterienverschlusses. Herz. 2011;36:222–231. [Article in German] - PubMed
- Delacrétaz E., Meier B. Therapeutic strategy with total coronary artery occlusions. Am J Cardiol. 1997;79:185–187. - PubMed
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