Korean Circ J.  2010 May;40(5):209-215. 10.4070/kcj.2010.40.5.209.

Percutaneous Recanalization of Coronary Chronic Total Occlusions: Current Devices and Specialized Wire Crossing Techniques

• Kim HY

• KMID: 1456363
• DOI: http://doi.org/10.4070/kcj.2010.40.5.209

Abstract

Treatment of coronary chronic total occlusions (CTOs) remains a challenging obstacle, posing a considerable barrier to achieving successful complete revascularization. By nature of their complexity, percutaneous CTO interventions are associated with lower rates of procedural success, higher complication rates, greater radiation exposure and longer procedure times compared with non-CTO interventions. In the last few years, development in guidewires, devices and the emergence of new techniques from Japanese centers resulted in higher success rates in the hands of experienced operators. The impact of drug eluting stents on restenosis has improved long-term outcomes after successful recanalization. Successful revascularization is associated with improved long-term survival, reduced symptoms, improved left ventricular function and reduced need for coronary bypass surgery. This paper reviews the current devices and specialized crossing techniques of percutaneous intervention to relieve CTOs.

Keyword

Angioplasty; Coronary occlusion

MeSH Terms

Angioplasty
Asian Continental Ancestry Group
Coronary Occlusion
Drug-Eluting Stents
Hand
Humans
Ventricular Function, Left

Figure

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  Fig. 1 Measurement of tip hardness of Miracle 3 wire.

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  Fig. 2 The concept of IVUS-guided penetration technique: from false lumen to true lumen. IVUS: intravascular ultrasound.

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  Fig. 3 Schema of different steps of the CART technique. CART: controlled antegrade and retrograde subintimal tracking.

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