The treatment of chronic total occlusion (CTO) of coronary arteries is a challenge
for physicians. In recent years, CTO treatment with percutaneous coronary intervention
(PCI) has increased with procedural success rates as high as 70% [
[1]
]. However, CTO-PCI treatment is questionable as a recent presentation of the DECISION-CTO
trial demonstrated no clinical outcome benefit over maximum medical therapy. In contrast,
the EURO-CTO trail demonstrated improved health status and functional class as compared
to medical management. The ACC/AHA guidelines for CTO-PCI management carries a class
IIa indication as the level of evidence is C [
- Teramoto T.
- Tsuchikane E.
- Matsuo H.
- Suzuki Y.
- Ito T.
- Ito T.
- et al.
Initial success rate of percutaneous coronary intervention for chronic total occlusion
in a native coronary artery is decreased in patients who underwent previous coronary
artery bypass graft surgery.
JACC Cardiovasc Interv. 2014; 7: 39-46
[2]
]. Mechanical circulatory support (MCS) devices have increasingly been used for the
treatment of coronary artery disease (CAD) undergoing percutaneous management [
- Levine G.N.
- Bates E.R.
- Blankenship J.C.
- Bailey S.R.
- Bittl J.A.
- Cercek B.
- et al.
ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention. A report of the American
College of Cardiology Foundation/American Heart Association Task Force on Practice
Guidelines and the Society for Cardiovascular Angiography and Interventions.
J. Am. Coll. Cardiol. 2011; 58: e44-122
[3]
]. There remains, however, a dearth of scientific evidence that directs the management
of patients with stable CAD. This study demonstrates the utilization trends and in-hospital
outcomes when using MCS for CTO-PCI hospitalizations presented with stable CAD.Keywords
Abbreviations:
CTO (chronic total occlusion), PCI (percutaneous coronary intervention)To read this article in full you will need to make a payment
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References
- Initial success rate of percutaneous coronary intervention for chronic total occlusion in a native coronary artery is decreased in patients who underwent previous coronary artery bypass graft surgery.JACC Cardiovasc Interv. 2014; 7: 39-46
- ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions.J. Am. Coll. Cardiol. 2011; 58: e44-122
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Article info
Publication history
Published online: September 17, 2018
Accepted:
September 11,
2018
Received:
September 6,
2018
Identification
Copyright
© 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
