163
Views
1
CrossRef citations to date
0
Altmetric
Review Articles

Percutaneous coronary interventions of chronic total ­occlusions; a review of clinical indications, treatment strategy and current practice

, MB, BCh, MD, , MD, , MD, PhD & , MD, PhD
Pages 357-369 | Received 31 May 2016, Accepted 27 Sep 2016, Published online: 14 Jul 2017

REFERENCES

  • Sianos G, Werner GS, Galassi AR, Papafaklis MI, Escaned J, Hildick-Smith D, Christiansen EH, Gershlick A, Carlino M, Karlas A, Konstantinidis NV, Tomasello SD, Di Mario C, Reifart N; EuroCTO Club. Recanalisation of chronic total coronary occlusions: 2012 consensus document from the EuroCTO club. EuroIntervention 2012; 8: 139–45.
  • Fefer P, Knudtson ML, Cheema AN, Galbraith PD, Osherov AB, Yalonetsky S. Gannot S, Samuel M, Weisbrod M, Bierstone D, Sparkes JD, Wright GA, Strauss BH. Current perspectives on coronary chronic total occlusions: the Canadian Multicenter Chronic Total Occlusions Registry. J Am Coll Cardiol 2012; 59: 991–7.
  • Jeroudi OM, Alomar ME, Michael TT, El Sabbagh A, Patel VG, Mogabgab O, Fuh E, Sherbet D, Lo N, Roesle M, Rangan BV, Abdullah SM, Hastings JL, Grodin J, Banerjee S, Brilakis ES. Prevalence and management of coronary chronic total occlusions in a tertiary veterans affairs hospital. Catheter Cardiovasc Interv 2014; 84: 637–43.
  • Hoye A, van Domburg RT, Sonnenschein K, Serruys PW. Percutaneous coronary intervention for chronic total occlusions: the Thoraxcenter experience 1992–2002. Eur Heart J 2005; 26: 2630–6.
  • Suero JA, Marso SP, Jones PG, Laster SB, Huber KC, Giorgi LV, Johnson WL, Rutherford BD. Procedural outcomes and long- term survival among patients undergoing percutaneous coronary intervention of a chronic total occlusion in native coronary arteries: a 20-year experience. J Am Coll Cardiol 2001; 38: 409–14.
  • Galassi AR, Boukhris M, Tomasello SD, Incidence, treatment, and in-hospital outcome of bifurcation lesions in patients undergoing percutaneous coronary interventions for chronic total occlusions. Coron Artery Dis 2015; 26: 142–9.
  • Farooq V, Serruys PW, Garcia-Garcia HM, Zhang Y, Bourantas CV, Holmes DR, Mack M, Feldman T, Morice MC, Ståhle E, James S, Colombo A, Diletti R, Papafaklis MI, de Vries T, Morel MA, van Es GA, Mohr FW, Dawkins KD, Kappetein AP, Sianos G, Boersma E. The negative impact of incomplete angiographic revascularization on clinical outcomes and its association with total occlusions: the SYNTAX (Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery) trial. J Am Coll Cardiol 2013; 61: 282–94.
  • Claessen BE, Dangas GD, Weisz G, Witzenbichler B, Guagliumi G, Möckel M, Brener SJ, Xu K, Henriques JP, Mehran R, Stone GW. Prognostic impact of a chronic total occlusion in a non-infarct-related artery in patients with ST-segment elevation myocardial infarction: 3-year results from the HORIZONS-AMI trial. Eur Heart J 2012; 33: 768–75.
  • Lexis CP, van der Horst IC, Rahel BM, Lexis MA, Kampinga MA, Gu YL, de Smet BJ, Zijlstra F. Impact of chronic total occlusions on markers of reperfusion, infarct size, and long-term mortality: a substudy from the TAPAS-trial. Catheter Cardiovasc Interv 2011; 77: 484–91.
  • Bataille Y, Déry JP, Larose É, Déry U, Costerousse O, Rodés-Cabau J, Gleeton O, Proulx G, Abdelaal E, Machaalany J, Nguyen CM, Noël B, Bertrand OF. Deadly association of cardiogenic shock and chronic total occlusion in acute ST-elevation myocardial infarction. Am Heart J 2012; 164: 509–15.
  • Hoebers LP, Vis MM, Claessen BE, van der Schaaf RJ, Kikkert WJ, Baan J Jr, de Winter RJ, Piek JJ, Tijssen JG, Dangas GD, Henriques JP. The impact of multivessel disease with and without a co-existing chronic total occlusion on short- and long-term mortality in ST-elevation myocardial infarction patients with and without cardiogenic shock. Eur J Heart Fail 2013; 15: 425–32.
  • Choi J-H, Chang S-A, Choi J-O, Song YB, Hahn JY, Choi SH, Lee SC, Lee SH, Oh JK, Choe Y, Gwon HC. Frequency of myocardial infarction and its relationship to angiographic collateral flow in territories supplied by chronically occluded coronary arteries. Circulation 2013; 127: 703–9.
  • Kumbasar D, Akyürek O, Dincer I, Atmaca Y, Kiliçkap M, Erol C, Oral D. Good collaterals predict viable myocardium. Angiology 2007; 58: 550–5.
  • Werner GS, Fritzenwanger M, Prochnau D, Schwarz G, Ferrari M, Aarnoudse W, Pijls NH, Figulla HR. Determinants of coronary steal in chronic total coronary occlusions. J Am Coll Cardiol 2006; 48: 51–8.
  • Jang WJ, Yang JH, Choi SH, Song YB, Hahn JY, Choi JH, Kim WS, Lee YT, Gwon HC. Long-term survival benefit of revascularization compared with medical therapy in patients with coronary chronic total occlusion and well-developed collateral circulation. JACC Cardiovasc Interv 2015; 8: 271–9.
  • Stuijfzand W, Driessen R, Raijmakers R, Rijnierse M, Maeremans J, Hollander M, Lammertsma A, Van Rossum A, Dens J, Nap A, Van Royen N, Knaapen P. Prevalence of ischaemia in patients with a CTO and preserved left ventricular ejection fraction. Eur Heart J Cardiovasc Imaging 2016 Sep 1 (Epub ahead of print).
  • Sachdeva R, Agrawal M, Flynn SE, Werner GS, Uretsky BF. The myocardium supplied by a chronic total occlusion is a persistently ischemic zone. Catheter Cardiovasc Interv 2014; 83: 9–16.
  • Barbato E, Wijns W. Are we ready for a new paradigm shift in percutaneous revascularization of chronically occluded vessels with well-developed collaterals?: from leaving ’em all to stenting ‘em all. JACC Cardiovasc Interv 2015; 8: 280–2.
  • Khan MF, Wendel CS, Thai HM, Movahed MR. Effects of percutaneous revascularization of chronic total occlusions on clinical outcomes: a meta-analysis comparing successful versus failed percutaneous intervention for chronic total occlusion. Catheter Cardiovasc Interv 2013; 82: 95–107.
  • Valenti R, Migliorini A, Signorini U, Vergara R, Parodi G, Carrabba N, Cerisano G, Antoniucci D. Impact of complete revascularization with percutaneous coronary intervention on survival in patients with at least one chronic total occlusion. Eur Heart J 2008; 29: 2336–42.
  • Hoebers LP, Claessen BE, Elias J, Dangas GD, Mehran R, Henriques JP. Meta-analysis on the impact of percutaneous coronary intervention of chronic total occlusions on left ventricular function and clinical outcome. Int J Cardiol 2015; 187: 90–6.
  • Kirschbaum SW, Baks T, van den Ent M, Sianos G, Krestin GP, Serruys PW, de Feyter PJ, van Geuns RJ. Evaluation of left ventricular function three years after percutaneous recanalization of chronic total coronary occlusions. Am J Cardiol 2008; 101: 179–85.
  • Kirschbaum SW, Rossi A, Boersma E, Springeling T, van de Ent M, Krestin GP, Serruys PW, Duncker DJ, de Feyter PJ, van Geuns RJ. Combining magnetic resonance viability variables better predicts improvement of myocardial function prior to percutaneous coronary intervention. Int J Cardiol 2012; 159: 192–7.
  • Borgia F, Viceconte N, Ali O, Stuart-Buttle C, Saraswathyamma A, Parisi R, Mirabella F, Dimopoulos K, Di Mario C. Improved cardiac survival, freedom from MACE and angina-related quality of life after successful percutaneous recanalization of coronary artery chronic total occlusions. Int J Cardiol 2012; 161: 31–8.
  • George S, Cockburn J, Clayton TC, Ludman P, Cotton J, Spratt J, Redwood S, de Belder M, de Belder A, Hill J, Hoye A, Palmer N, Rathore S, Gershlick A, Di Mario C, Hildick-Smith D; British Cardiovascular Intervention Society; National Institute for Cardiovascular Outcomes Research. Long-term follow-up of elective chronic total coronary occlusion angioplasty: analysis from the U.K. Central Cardiac Audit Database. J Am Coll Cardiol 2014; 64: 235–43.
  • Wijeysundera HC, Norris C, Fefer P, Galbraith PD, Knudtson ML, Wolff R, Wright GA, Strauss BH, Ko DT. Relationship between initial treatment strategy and quality of life in patients with coronary chronic total occlusions. EuroIntervention 2014; 9: 1165–72.
  • Galassi AR, Sianos G, Werner GS, Escaned J, Tomasello SD, Boukhris M, Castaing M, Büttner JH, Bufe A, Kalnins A, Spratt JC, Garbo R, Hildick-Smith D, Elhadad S, Gagnor A, Lauer B, Bryniarski L, Christiansen EH, Thuesen L, Meyer-Geßner M, Goktekin O, Carlino M, Louvard Y, Lefèvre T, Lismanis A, Gelev VL, Serra A, Marzà F, Di Mario C, Reifart N; Euro CTO Club. Retrograde recanalization of chronic total occlusions in Europe: procedural, in-hospital, and long-term outcomes from the Multicenter ERCTO registry. J Am Coll Cardiol 2015; 65: 2388–400.
  • Michael TT, Karmpaliotis D, Brilakis ES, Fuh E, Patel VG, Mogabgab O, Alomar M, Kirkland BL, Lembo N, Kalynych A, Carlson H, Banerjee S, Lombardi W, Kandzari DE. Procedural outcomes of revascularization of CTO of native coronary arteries. Am J Cardiol 2013; 112: 488–92.
  • Meissner MD, Akhtar M, Lehmann MH. Nonischemic sudden tachyarrhythmic death in atherosclerotic heart disease. Circulation 1991; 84: 905–12.
  • Nombela-Franco L, Mitroi CD, Fernández-Lozano I, García-Touchard A, Toquero J, Castro-Urda V, Fernández-Diaz JA, Perez-Pereira E, Beltrán-Correas P, Segovia J, Werner GS, Javier G, Luis AP. l. Ventricular arrhythmias among implantable cardioverter-defibrillator recipients for primary prevention: impact of chronic total coronary occlusion (VACTO Primary Study). Circ Arrhythm Electrophysiol 2012; 5: 147–54.
  • Yang ZK, Zhang RY, Hu J, Zhang Q, Ding FH, Shen WF. Impact of successful staged revascularization of a CTO in the non-infarct-related artery on long-term outcome in patients with acute STEMI. Int J Cardiol 2013; 165: 76–9.
  • Jose P. Henriques; Loes Hoebers; Truls Råmunddal; Peep Laanmets; Erlend Eriksen; Matthijs Bax; Dan Ioanes; Maarten J. Suttorp; Bradley Strauss; Emanuele Barbato; Robin Nijveldt; Albert C. van Rossum; Koen Marques; Jan G. Tijssen; Rene J. van der Schaaf. First results of the EXPLORE trial, a Global, Randomized, Prospective, Multicenter Trial Investigating the Impact of Recanalization of a Chronic Total Occlusion on Left Ventricular Function in Patients after Primary Percutaneous Coronary Intervention for Acute ST-Elevation Myocardial Infarction (abstract). J Am Coll Cardiol 2015; 66 (suppl 15_S).
  • Mehran R, Claessen BE, Godino C, Dangas GD, Obunai K, Kanwal S, Carlino M, Henriques JP, Di Mario C, Kim YH, Park SJ, Stone GW, Leon MB, Moses JW, Colombo A; Multinational Chronic Total Occlusion Registry. Long-term outcome of PCI for CTO. JACC Cardiovasc Interv 2011; 4: 952–61.
  • Jones DA, Weerackody R, Rathod K, Behar J, Gallagher S, Knight CJ, Kapur A, Jain AK, Rothman MT, Thompson CA, Mathur A, Wragg A, Smith EJ. Successful recanalization of CTO is associated with improved long-term survival. JACC Cardiovasc Interv 2012; 5: 380–8.
  • Hachamovitch R, Rozanski A, Shaw LJ, Stone GW, Thomson LE, Friedman JD, Hayes SW, Cohen I, Germano G, Berman DS. Impact of ischaemia and scar on the therapeutic benefit derived from myocardial revascularization vs. medical therapy among patients undergoing stress-rest myocardial perfusion scintigraphy. Eur Heart J 2011; 32: 1012–24.
  • Jolicoeur EM, Sketch MJ, Wojdyla DM, Javaheri SP, Nosib S, Lokhnygina Y, Patel MR, Shaw LK, Tcheng JE. PCI and cardiovascular outcomes for patients with CTO. Catheter Cardiovasc Interv 2012; 79: 603–12.
  • de Labriolle A, Bonello L, Roy P, Lemesle G, Steinberg DH, Xue Z, Kaneshige K, Suddath WO, Satler LF, Kent KM, Pichard AD, Lindsay J, Waksman R. Comparison of safety, efficacy, and outcome of successful versus unsuccessful PCI in “true” CTO. Am J Cardiol 2008; 102: 1175–1181.
  • Chen SL, Ye F, Zhang JJ, Lin S, Zhu ZS, Tian NL, Liu ZZ, Sun XW, Zhang AP, Chen F, Ding SQ, Chen J. Clinical outcomes of PCI for CTO lesions in remote hospitals without on-site surgical support. Chin Med J (Engl) 2009; 122: 2278–85.
  • Shaw LJ, Berman DS, Maron DJ, Mancini GB, Hayes SW, Hartigan PM, Weintraub WS, O’Rourke RA, Dada M, Spertus JA, Chaitman BR, Friedman J, Slomka P, Heller GV, Germano G, Gosselin G, Berger P, Kostuk WJ, Schwartz RG, Knudtson M, Veledar E, Bates ER, McCallister B, Teo KK, Boden WE; COURAGE Investigators. Optimal medical therapy with or without percutaneous coronary intervention to reduce ischemic burden: results from the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial nuclear substudy. Circulation 2008; 117: 1283–91.
  • Galassi AR, Werner GS, Tomasello SD, Azzarelli S, Capodanno D, Barrano G, Marza’ F, Costanzo L, Campisano M, Tamburino C. Prognostic value of exercise myocardial scintigraphy in patients with coronary chronic total occlusions. J Interv Cardiol 2010; 23: 139–48.
  • Safley DM, Koshy S, Grantham JA, Bybee KA, House JA, Kennedy KF, Rutherford BD. Changes in myocardial ischemic burden following percutaneous coronary intervention of chronic total occlusions. Catheter Cardiovasc Interv 2011; 78: 337–43.
  • Sianos G, Konstantinidis NV, Di Mario C, Karvounis H. Theory and practical based approach to chronic total occlusions. BMC Cardiovasc Disord 2016; 16: 33.
  • Windecker S, Kolh P, Alfonso F, Collet JP, Cremer J, Falk V, Filippatos G, Hamm C, Head SJ, Jüni P, Kappetein AP, Kastrati A, Knuuti J, Landmesser U, Laufer G, Neumann FJ, Richter DJ, Schauerte P, Sousa Uva M, Stefanini GG, Taggart DP, Torracca L, Valgimigli M, Wijns W, Witkowski A. 2014 ESC/EACTS guidelines on myocardial revascularization. EuroIntervention 2015; 10: 1024–94.
  • Brilakis ES, Grantham JA, Rinfret S, Wyman RM, Burke MN, Karmpaliotis D, Lembo N, Pershad A, Kandzari DE, Buller CE, DeMartini T, Lombardi WL, Thompson CA. A percutaneous treatment algorithm for crossing coronary chronic total occlusions. JACC Cardiovasc interv 2012; 5: 367–79.
  • Morino Y, Abe M, Morimoto T, Kimura T, Hayashi Y, Muramatsu T, Ochiai M, Noguchi Y, Kato K, Shibata Y, Hiasa Y, Doi O, Yamashita T, Hinohara T, Tanaka H, Mitsudo K; J-CTO Registry Investigators. Predicting successful guidewire crossing through chronic total occlusion of native coronary lesions within 30 minutes: The J-CTO (Multicenter CTO Registry in Japan) score as a difficulty grading and time assessment tool. JACC Cardiovasc interv 2011; 4: 213–21.
  • Werner GS. The BridgePoint devices to facilitate recanalization of chronic total coronary occlusions through controlled subintimal reentry. Expert Rev Med Dev 2011; 8: 23–9.
  • Christopoulos G, Menon RV, Karmpaliotis D, Alaswad K, Lombardi W, Grantham A, Patel VG, Rangan BV, Kotsia AP, Lembo N, Kandzari D, Carlson H, Garcia S, Banerjee S, Thompson CA, Brilakis ES. The efficacy and safety of the «hybrid» approach to coronary chronic total occlusions: insights from a contemporary multicenter US registry and comparison with prior studies. J Invasive Cardiol 2014; 26: 427–32.
  • Patel VG, Brayton KM, Tamayo A, Mogabgab O, Michael TT, Lo N, Alomar M, Shorrock D, Cipher D, Abdullah S, Banerjee S, Brilakis ES. Angiographic success and procedural complications in patients undergoing percutaneous coronary chronic total occlusion interventions: a weighted meta-analysis of 18,061 patients from 65 studies. JACC Cardiovasc interv 2013; 6: 128–36.
  • Saeed B, Kandzari DE, Agostoni P, Lombardi WL, Rangan BV, Banerjee S, Brilakis ES. Use of drug-eluting stents for chronic total occlusions: a systematic review and meta-analysis. Catheter Cardiovasc Interv 2011; 77: 315–32.
  • Maeremans J, Knaapen P, Stuijfzand WJ, Kayaert P, Pereira B, Barbato E, Dens J. Antegrade wire escalation for chronic total occlusions in coronary arteries: simple algorithms as a key to success. J Cardiovasc Med (Hagerstown) 2016; 17: 680–6.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.