Percutaneous revascularization of chronic total occlusions Rationale, indications, techniques, and the cardiac surgeons point of view.pdfVIP
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Percutaneous revascularization of chronic total occlusions Rationale, indications, techniques, and the cardiac surgeons point of view.pdf
International Journal of Cardiology 231 (2017) 90–96
Contents lists available at ScienceDirect
International Journal of Cardiology
journal homepage: /locate/ijcard
Percutaneous revascularization of chronic total occlusions: Rationale,
indications, techniques, and the cardiac surgeons point of view
Lorenzo Azzalini a,?, Gianluca Torregrossa b, John D. Puskas b, Emmanouil S. Brilakis c, William L. Lombardi d,
Dimitri Karmpaliotis e, Sunao Nakamura f, Antonio Colombo a, Mauro Carlino a
a Division of Interventional Cardiology, Cardio-Thoracic-Vascular Department, San Raffaele Scienti?c Institute, Milan, Italy b Division of Cardiovascular Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA c Minneapolis Heart Institute, Minneapolis, MN, USA d Division of Cardiology, Department of Medicine, University of Washington Medical Center, Seattle, WA, USA e Center for Interventional Vascular Therapy, Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY, USA f Division of Cardiology, Department of Medicine, New Tokyo Hospital, Chiba, Japan
article info
Article history: Received 1 January 2017 Accepted 3 January 2017 Available online 5 January 2017
Keywords: Chronic total occlusion Revascularization Percutaneous coronary intervention Coronary artery bypass graft Hybrid revascularization
abstract
Chronic total occlusions (CTO) are frequently found in clinical practice, yet they are still undertreated, despite the frequent presence of clinical indications for revascularization. The presence of a CTO is a frequent cause of incomplete revascularization, which has been associated with worse long-term outcomes (including mortality), compared to complete revascularization. Such low rates of attempted revascularization can be attributed to a common misconception about the lack of bene?t of CTO revascularization, combined with historically lower success rates and higher complication rates of CTO percutaneous
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