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The Impact of Coronary Physiology on Contemporary Clinical Decision Making Neoatherosclerosis in Patients With Coronary Stent Thrombosis: Findings From Optical Coherence Tomography Imaging (A Report of the PRESTIGE Consortium) Characteristics of stent thrombosis in bifurcation lesions analysed by optical coherence tomography Prognostic Implications of Plaque Characteristics and Stenosis Severity in Patients With Coronary Artery Disease Utilization and Outcomes of Measuring Fractional Flow Reserve in Patients With Stable Ischemic Heart Disease The impact of downstream coronary stenoses on fractional flow reserve assessment of intermediate left main disease A new optical coherence tomography-based calcium scoring system to predict stent underexpansion Fractional flow reserve in clinical practice: from wire-based invasive measurement to image-based computation Percutaneous Coronary Intervention For Bifurcation Coronary Lesions.The 15th Consensus Document from the European Bifurcation Club Impact of low tissue backscattering by optical coherence tomography on endothelial function after drug-eluting stent implantation
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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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