Background: Chronic total occlusion (CTO) of a coronary artery is defined as an occluded
segment with no antegrade flow and a known or estimated duration of at least 12 weeks.
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Objective: We considered the current literature describing the indications and clinical outcomes for denovo
CTO- percutaneous coronary intervention (PCI), and discuss the role of CTO-PCI and future directions
for this procedure.
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Methods: Databases (PubMed, the Cochrane Library, Embase, EBSCO, Web of Science, and CINAHL
were searched and relevant studies of CTO-PCI were selected for review.
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Results: The prevalence of coronary artery CTO’s has been reported to be ~ 20% among patients undergoing
diagnostic coronary angiography for suspected coronary artery disease. Revascularization of
any CTO can be technically challenging and a time-consuming procedure with relatively low success
rates and may be associated with a higher incidence of complications, particularly at non-specialized
centers. However, with an increase in experience and technological advances, several centers are now
reporting success rates above 80% for these lesions. There is marked variability among studies in reporting
outcomes for CTO-PCI with some reporting potential mortality benefit, better quality of life and
improved cardiac function parameters. Anecdotally, properly selected patients who undergo a successful
CTO-PCI most often have profound relief of ischemic symptoms. Intuitively, it makes sense to revascularize
an occluded coronary artery with the goal of improving cardiovascular function and patient quality
of life.
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Conclusion: CTO-PCI is a rapidly expanding specialized procedure in interventional cardiology and is
reasonable or indicated if the occluded vessel is responsible for symptoms or in selected patients with
silent ischemia in whom there is a large amount of myocardium at risk and PCI is likely to be successful.
PCV28 HEALTH-RELATED QUALITY OF LIFE AFTER PERCUTANEOUS CORONARY INTERVENTION IN PATIENTS WITH ACUTE CORONARY SYNDROMES
