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Early Surgery or Conservative Care for Asymptomatic Aortic Stenosis Novel predictors of late lumen enlargement in distal reference segments after successful recanalization of coronary chronic total occlusion Longitudinal Change in Galectin-3 and Incident Cardiovascular Outcomes Long-term effects of intensive glucose lowering on cardiovascular outcomes A Combined Optical Coherence Tomography and Intravascular Ultrasound Study on Plaque Rupture, Plaque Erosion, and Calcified Nodule in Patients With ST-Segment Elevation Myocardial Infarction: Incidence, Morphologic Characteristics, and Outcomes After Percutaneous Coronary Intervention 2019 Guidelines on Diabetes, Pre-Diabetes and Cardiovascular Diseases developed in collaboration with the EASD ESC Clinical Practice Guidelines Transcatheter versus Surgical Aortic Valve Replacement in Patients with Prior Cardiac Surgery in the Randomized PARTNER 2A Trial Impact of Positive and Negative Lesion Site Remodeling on Clinical Outcomes : Insights From PROSPECT Rationale and design of a large-scale, app-based study to identify cardiac arrhythmias using a smartwatch: The Apple Heart Study The Evolution of β-Blockers in Coronary Artery Disease and Heart Failure (Part 1/5)
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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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