Contemporary techniques for coronary CTO revascularization.
Panminerva Med
; 59(1): 47-66, 2017 Mar.
Article
en En
| MEDLINE
| ID: mdl-27759734
Despite permanent improvement in success rate and technical developments, chronic total occlusion (CTO) remains undertreated by percutaneous coronary intervention (PCI). Dedicated CTO operators from Japan, Europe and USA perform these procedures with success rate beyond 90%, but there is still huge gap between this group of specialists and broader population of PCI operators. Recently proposed CTO scores can be used for patients' selection according to the CTO operators' experience. Patients with low CTO Score values may be suitable for less experienced operators at the beginning of the CTO PCI learning curve, while more complex CTOs (higher CTO Score values) should be differed to CTO experts. As most of CTO scores better predict antegrade procedural success, at the hands of expert CTO operators, lower or intermediate CTO Score values suggest cases which could be started by anterograde techniques. In this paper we review: 1) an impact of CTO on completeness of revascularization; 2) appropriate CTO equipment setting; 3) procedure planning aspects, including the use of computed tomography angiography and CTO scores; 4) current CTO techniques classifying them into A) antegrade, B) retrograde and C) hybrid approach. Further advancements in CTO PCI should not only provide higher rate of complete revascularization, with improved clinical outcome, but also simplify procedure and make it suitable for broader spectrum of interventionalists.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Oclusión Coronaria
/
Intervención Coronaria Percutánea
/
Revascularización Miocárdica
Tipo de estudio:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
País/Región como asunto:
America do norte
/
Asia
/
Europa
Idioma:
En
Revista:
Panminerva Med
Año:
2017
Tipo del documento:
Article
Pais de publicación:
Italia