Chronic Total Occlusion Percutaneous Coronary Intervention: Present and Future
Recommended Citation
Brilakis ES, Sandoval Y, Azzalini L, Leibundgut G, Garbo R, Hall AB, Davies R, Mashayekhi K, Yamane M, Avran A, Khatri J, Alaswad K, Jaffer FA, and Rinfret S. Chronic Total Occlusion Percutaneous Coronary Intervention: Present and Future. Circ Cardiovasc Interv 2025;18(6):14801.
Document Type
Article
Publication Date
6-1-2025
Publication Title
Circ Cardiovasc Interv
Abstract
Chronic total occlusion percutaneous coronary intervention has evolved into a subspecialty of interventional cardiology. Using a variety of antegrade and retrograde techniques, experienced operators currently achieve success rates of 85% to 90%, with an incidence of major periprocedural complications of ≈ 2% to 3%. Several developments in equipment (new microcatheters and guidewires, novel reentry devices), imaging (computed tomography angiography guidance, intravascular imaging for reentry), techniques (intraocclusion contrast injection, advanced subintimal tracking and reentry), and artificial intelligence (automated computed tomography image analysis and prediction of the likelihood of crossing success with various techniques) could further improve outcomes. Global collaboration and rapid dissemination of new developments accelerate the pace of progress. While innovation is exciting and necessary, adhering to the basic principles of chronic total occlusion percutaneous coronary intervention (such as continual assessment of risks and benefits, meticulous angiographic review, and use of dual injection) remains critical for achieving optimal patient outcomes.
Medical Subject Headings
Humans; Percutaneous Coronary Intervention; Coronary Occlusion; Chronic Disease; Treatment Outcome; Risk Factors; Coronary Angiography; Forecasting; Predictive Value of Tests; Diffusion of Innovation
PubMed ID
40223600
ePublication
ePub ahead of print
Volume
18
Issue
6
First Page
014801
Last Page
014801
