Masahisa Yamane, Kenya Nasu, Masaaki Okutsu, Makoto Sekiguchi
Chronic total occlusion
Updated on August 26, 2021
Chronic total occlusion
Chronic total occlusions
Updated on May 13, 2021 | 11 minutes reading
Summary
Chronically occluded coronary lesions make up about 20% of all coronary lesions, but because a lesion is totally occluded it is often considered differently from a non-occlusive lesion regarding the indication of an intervention. There are numerous studies including a recent randomized trial to support the rationale of reopening a chronic total coronary occlusion (CTO) if viability and ischaemia are demonstrated in the territory distal to the CTO. The reluctance of many operators to attempt a CTO as a target lesion is rather based on the complexity of the procedure, and the limited success rate than on any evidence that a CTO is a benign lesion. However, recent developments in the technical approach, both in strategy as well as available tools, have led to a greatly improved success rate for the recanalization of a CTO which is now above 90% in experienced hands. Furthermore, persistent patency and low lesion recurrence can be achieved through the use of drug-eluting stents (DES). To achieve these improvements in technical success, operators need to undertake specialised training, and must become familiar with the specific tools and techniques of CTO intervention.
Definition and classification
A chronic total occlusion (CTO) describes a completely occluded coronary...
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