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Chronic Total Occlusion Interventions: Update on Current Tips and Tricks

  • New Therapies for Cardiovascular Disease (AA Bavry, Section Editor)
  • Published:
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Abstract

Purpose of Review

To summarize novel techniques and developments in chronic total occlusion (CTO) percutaneous coronary intervention (PCI).

Recent Findings

Using an algorithmic, step-by-step approach can help overcome several complex CTO lesions subsets, such as proximal cap ambiguity, ostial location, in-stent occlusion, bifurcations, balloon uncrossable and undilatable lesions. Similarly, an algorithmic approach can help prevent and optimally treat CTO PCI-related complication, such as perforation, radiation, and contrast-induced nephropathy.

Summary

Continual update and reassessment of each operator’s algorithm for performing CTO PCI can lead to improved outcomes.

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References

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

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Authors and Affiliations

  1. Minneapolis Heart Institute, Abbott Northwestern Hospital, 920 E 28th Street #300, Minneapolis, MN, 55407, USA

    Peter Tajti, Iosif Xenogiannis, M. Nicholas Burke & Emmanouil S. Brilakis

  2. Department of Invasive Cardiology, Second Department of Internal Medicine and Cardiology Center, Univeristy of Szeged, Szeged, Hungary

    Peter Tajti & Imre Ungi

  3. Columbia University, New York, NY, USA

    Dimitris Karmpaliotis

  4. Henry Ford Hospital, Detroit, MI, USA

    Khaldoon Alaswad

  5. Massachussetts General Hospital, Boston, MA, USA

    Farouc A. Jaffer

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  1. Peter Tajti
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Correspondence to Emmanouil S. Brilakis.

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Conflict of Interest

Dimitri Karmpaliotis declares speaker honoraria from Abbott Vascular, Medtronic, Boston Scientifiic, and Vascular Solutions.

Khaldoon Alaswad declares consulting fees from Terumo and Boston Scientific; consultant, no financial, Abbott Laboratories.

Farouc A. Jaffer reports the following: Consultant: Abbott Vascular, Boston Scientific, Siemens and Philips. Research grant: Canon, Siemens, and National Institutes of Health.

M. Nicholas Burke declares consulting and speaker honoraria from Abbott Vascular and Boston Scientific.

Emmanouil S. Brilakis declares consulting/speaker honoraria from Abbott Vascular, ACIST, Amgen, Asahi, CSI, Elsevier, GE Healthcare, Medicure, and Nitiloop; research support from Boston Scientific and Osprey. Board of Directors: Cardiovascular Innovations Foundation. Board of Trustees: Society of Cardiovascular Angiography and Interventions. American Heart Association (associate editor Circulation). MHI Ventures, shareholder.

Peter Tajti, Iosif Xenogiannis, and Imre Ungi declare that they have no conflict of interest.

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Tajti, P., Xenogiannis, I., Karmpaliotis, D. et al. Chronic Total Occlusion Interventions: Update on Current Tips and Tricks. Curr Cardiol Rep 20, 141 (2018). https://doi.org/10.1007/s11886-018-1083-7

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