Myths to Debunk to Improve Management, Referral, and Outcomes in Patients With Chronic Total Occlusion of an Epicardial Coronary Artery

Am J Cardiol. 2015 Dec 1;116(11):1774-80. doi: 10.1016/j.amjcard.2015.08.050. Epub 2015 Sep 11.

Abstract

A chronic total occlusion (CTO) is defined as an occlusive (100% stenosis) coronary lesion with anterograde Thrombolysis In Myocardial Infarction 0 flow for at least 3 months. CTOs are common in patients referred for coronary angiography (up to 33%) and are associated with angina, impaired quality of life, and reduced survival. Unfortunately, CTO percutaneous coronary intervention continues to be underperformed worldwide (10% to 15% at most institutions, ∼30% where expert operators are available). The aim of this study was to address common fallacies pertaining to CTOs among cardiologists by providing a concise review of pertinent previously published reports along with an update on safety and efficacy of state-of-the-art CTO percutaneous coronary intervention techniques.

Trial registration: ClinicalTrials.gov NCT01078051 NCT01760083.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Coronary Artery Bypass*
  • Coronary Occlusion / surgery
  • Coronary Occlusion / therapy*
  • Humans
  • Patient Safety
  • Percutaneous Coronary Intervention*
  • Quality of Life

Associated data

  • ClinicalTrials.gov/NCT01078051
  • ClinicalTrials.gov/NCT01760083
  • NTR/NTR1108