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The evidence base for revascularisation of chronic total occlusions

Lookup NU author(s): Dr Alan Bagnall, Professor Ioakim SpyridopoulosORCiD


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© 2014 Bentham Science Publishers. When patients with ischaemic heart disease are considered for revascularisation the Heart Team’s aim is to choose a therapy that will provide complete relief of angina for an acceptable procedural risk. Complete functional revascularisation of ischaemic myocardium is thus the goal and for this reason the presence of a chronic total occlusion (CTO) - which remain the most technically challenging lesions to revascularise percutaneously - is the most common reason for selecting coronary artery bypass surgery [1]. From the behaviour of Heart Teams it is clear that physicians believe that CTOs are important. Yet when faced with patients with CTOs for whom surgery appears excessive (e.g. nonproximal LAD) or too high risk, there remains a reluctance to undertake CTO PCI, despite significant recent advances in procedural success and safety and a considerable body of evidence supporting a survival benefit following successful CTO PCI. This article reviews the relationship between CTOs, symptoms of angina, ischaemia and left ventricular dysfunction and further explores the evidence relating their treatment to improved quality of life and prognosis in patients with these features.

Publication metadata

Author(s): Bagnall A, Spyridopoulos I

Publication type: Article

Publication status: Published

Journal: Current Cardiology Reviews

Year: 2014

Volume: 10

Issue: 2

Pages: 88-98

Print publication date: 01/01/2014

Acceptance date: 01/01/1900

ISSN (print): 1573-403X

ISSN (electronic): 1875-6557

Publisher: Bentham Science Publishers B.V.


DOI: 10.2174/1573403X10666140331125659

PubMed id: 24694105


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