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Current treatment of significant left main coronary artery disease: A review Mechanisms of in-stent restenosis after drug-eluting stent implantation: intravascular ultrasound analysis Two-year outcomes following unprotected left main stenting with first vs new-generation drug-eluting stents: the FINE registry. EuroIntervention. The Science Underlying COVID-19: Implications for the Cardiovascular System Impact of Intravascular Ultrasound on Long-Term Clinical Outcomes in Patients With Acute Myocardial Infarction Anthracycline-induced cardiotoxicity: A multicenter randomised trial comparing two strategies for guiding prevention with enalapril: The International CardioOncology Society-one trial Risk of Coronary Obstruction and Feasibility of Coronary Access After Repeat Transcatheter Aortic Valve Replacement With the Self-Expanding Evolut Valve: A Computed Tomography Simulation Study Randomized study to evaluate sirolimus-eluting stents implanted at coronary bifurcation lesions Defining a new standard for IVUS optimized drug eluting stent implantation: the PRAVIO study P2Y12 Inhibitor Monotherapy with Clopidogrel Versus Ticagrelor in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention
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Review Article2018 Jan 12;7(2).

JOURNAL：J Am Heart Assoc. Article Link

Chronic Total Occlusion Percutaneous Coronary Intervention: Evidence and Controversies

Tajti P, Brilakis ES. Keywords: chronic total occlusion; complex coronary intervention; percutaneous coronary intervention; stable coronary artery disease

ABSTRACT

Coronary chronic total occlusions (CTOs) are defined as 100% occlusions with TIMI (Thrombolysis in Myocardial Infarction) 0 flow with at least a 3‐month duration. Treatment options for patients with coronary CTOs include lifestyle changes and medications (as is appropriate for all patients with coronary artery disease) and coronary revascularization with either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). In the previous version of the appropriateness use criteria for coronary revascularization, revascularization recommendations were different for patients with and without a coronary CTO, but this is no longer the case in the current (2016 and 2017) versions.


The goal of this review is to summarize the available evidence on the clinical benefits, likelihood of success, risk for complications, and crossing strategies for CTO PCI and provide practical clinical recommendations.
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