Results of coronary angioplasty of chronic total occlusions (the National Heart, Lung, and Blood Institute 1985–1986 Percutaneous Transluminal Angioplasty Registry)

Improved cardiac survival, freedom from mace and angina-related quality of life after successful percutaneous recanalization of coronary artery chronic total occlusions

“…The availability of new wires and support micro-catheters for CTO procedures in addition to the increased use of dual injection, retrograde approach and intravascular ultrasound guidance [4][5][6] have increased the success rate of CTO recanalization procedures, which moved from 50-60% [7,8] to more than 70-80% [9][10][11][12], with peaks above 90% for some high level centers in Japan [13,14]. Improved operators' skills and availability of drug-eluting stents reduced the incidence of periprocedural complications and late reocclusions, with adverse events mainly represented by benign periprocedural non-Q wave MI or small pericardial effusions [15,16].…”

Recanalization of chronic coronary occlusions using a new hydrophilic guidewire

“…However, chronic total occlusions account for only 10% of coronary angioplasty procedures [2] and are still considered a common contraindication for angioplasty, especially in the setting of multivessel disease. Compared to angioplasty of subtotal stenoses, chronic occlusion angioplasty is associated with lower success rates, increased costs, increased catheterization laboratory time and equipment use, and longer radiation exposure [3][4][5][6][7][8][9][10][11][12][13]. Despite improved procedural success, inability to cross the lesion with a guidewire remains the most frequent cause of failure [14].…”

Effect of preoperative evaluation by multidetector computed tomography in percutaneous coronary interventions of chronic total occlusions

“…It is considered that the prevalence of in-hospital major adverse events may be N5% in PCIs of CTOs [1,2,24]. Even in very experienced hands, peri-procedural myocardial infarction may occur in N2% of cases, emergency bypass surgery may be required in 1% of subjects, and death may occur in 1% of patients [21].…”