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Chronic Total Occlusions: Patient Selection and Overview of Advanced Techniques

  • Interventional Cardiology (S Rao, Section Editor)
  • Published:
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Abstract

Percutaneous treatment of coronary chronic total occlusions (CTOs) remains challenging, mainly due to difficulty in crossing the lesion. However tremendous progress has been achieved recently with expanded use of the retrograde approach and advanced dissection re-entry techniques. The development of the “hybrid” approach from North American operators has provided practical recommendations on how to select initial and subsequent CTO crossing strategies. Moreover, additional information has emerged on the frequency of CTOs among patients undergoing cardiac catheterization and on the adverse prognostic impact of CTOs on clinical outcomes of patients with ischemic cardiomyopathy who have implantable cardioverter defibrillators. Overall, CTO interventions remain a dynamic area with multiple novel technical and clinical developments.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Disclosures

Conflicts of interest: S. Garcia: is a recipient of a career development award (1IK2CX000699-01) from the VA Office of Research and Development; S. Abdullah: none; S. Banerjee: has served on the Speakers’ Bureau for St. Jude Medical Center, Medtronic Corp., and Johnson & Johnson and has received a research grant from Boston Scientific; has received grant support from Gilead Medicine Company; and spouse has received honoraria from Abbott; he has ownership interest in Hygeia Tel and spouse has ownership interest in Mdcare Global; E.S. Brilakis: has received speaker honoraria from St. Jude Medical, Terumo, and Bridgepoint Medical; and spouse is an employee of Medtronic; and has given expert testimony for Thompson, Coe, Cousins and Irons, LLP.

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Authors and Affiliations

  1. Minneapolis VA Healthcare System, One Veterans Drive (111-C), Minneapolis, MN, USA

    Santiago Garcia

  2. VA North Texas Healthcare System, Dallas, TX, USA

    Subhash Banerjee & Emmanouil S. Brilakis

  3. University of Texas Southwestern Medical Center, Dallas, TX, USA

    Shuaib Abdullah, Subhash Banerjee & Emmanouil S. Brilakis

  4. Dallas VA Medical Center (111A), 4500 South Lancaster Road, Dallas, TX, 75216, USA

    Shuaib Abdullah & Emmanouil S. Brilakis

Authors
  1. Santiago Garcia
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  2. Shuaib Abdullah
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  3. Subhash Banerjee
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  4. Emmanouil S. Brilakis
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Correspondence to Emmanouil S. Brilakis.

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This article is part of the Topical Collection on Interventional Cardiology

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Garcia, S., Abdullah, S., Banerjee, S. et al. Chronic Total Occlusions: Patient Selection and Overview of Advanced Techniques. Curr Cardiol Rep 15, 334 (2013). https://doi.org/10.1007/s11886-012-0334-2

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