TY - CHAP
T1 - Rationale and Technique for Percutaneous Coronary Intervention of Chronic Total Occlusions
AU - Claessen, Bimmer E.
AU - Henriques, José P.S.
N1 - Publisher Copyright: © 2015 Springer-Verlag Berlin Heidelberg, All rights reserved.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Chronic total occlusions (CTOs) represent the “last frontier” of percutaneous coronary interventions (PCI). CTOs are frequently (~30 %) detected on diagnostic coronary angiograms, but CTO PCI is currently performed infrequently mainly because of higher technical difficulty and perceived risk of complications. Nonetheless, successful CTO PCI can significantly improve the patient’s quality of life, improve left ventricular function, reduce the need for subsequent coronary artery bypass graft surgery, and possibly improve long-term survival. The introduction of novel catheters, guidewires, adjunctive imaging, PCI techniques, and higher operator volumes has led to an increased success rate of CTO PCI. Moreover, the introduction of drug-eluting stents has led to higher rates of sustained patency following CTO recanalization. This chapter aims to provide an overview of the anatomy and histopathology of CTOs, a concise review of techniques and devices for CTO PCI, and a comprehensive summary of the evidence regarding the clinical relevance and rationale of CTO PCI.
AB - Chronic total occlusions (CTOs) represent the “last frontier” of percutaneous coronary interventions (PCI). CTOs are frequently (~30 %) detected on diagnostic coronary angiograms, but CTO PCI is currently performed infrequently mainly because of higher technical difficulty and perceived risk of complications. Nonetheless, successful CTO PCI can significantly improve the patient’s quality of life, improve left ventricular function, reduce the need for subsequent coronary artery bypass graft surgery, and possibly improve long-term survival. The introduction of novel catheters, guidewires, adjunctive imaging, PCI techniques, and higher operator volumes has led to an increased success rate of CTO PCI. Moreover, the introduction of drug-eluting stents has led to higher rates of sustained patency following CTO recanalization. This chapter aims to provide an overview of the anatomy and histopathology of CTOs, a concise review of techniques and devices for CTO PCI, and a comprehensive summary of the evidence regarding the clinical relevance and rationale of CTO PCI.
UR - http://www.scopus.com/inward/record.url?scp=84956971691&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/978-3-642-37078-6_75
DO - https://doi.org/10.1007/978-3-642-37078-6_75
M3 - Chapter
SN - 9783642370779
SP - 2281
EP - 2296
BT - PanVascular Medicine, Second Edition
PB - Springer Berlin Heidelberg
ER -