Current Trend and Techniques of Percutaneous Coronary Intervention for Chronic Total Occlusion

Coronary chronic total occlusion (CTO) has been generally defined as complete occlusion of antegrade coronary flow with estimated occlusion for more than 3 months. It has been observed in approximately one-third of patients referred for cardiac catheterization. Over the last decade, percutaneous coronary intervention (PCI) for CTO has rapidly improved and become more generalized despite its technical challenges. Development of dedicated guidewires and microcatheters, implementation of new recanalization techniques, and accumulated experience of operators have increased the probability of procedural success and minimized the complication rate [6–8]. Benefits of successful CTO-PCI include reduced angina frequency and improvements in quality of life, left ventricular ejection fraction, or survival. Accordingly, clinical guidelines advocate considering CTO-PCI in patients with selected clinical indications. However, CTO-PCI can lead to procedure-related complications including perforation, myocardial injury, or loss of recruitable collateral flow.