Chronic Total Occlusion Percutaneous Coronary Intervention: Present and Future

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

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