Korean Circ J.  2008 Jun;38(6):295-300. 10.4070/kcj.2008.38.6.295.

Recent Progress of the Use of Interventional Therapy for Chronic Total Occlusion

• Nakamura S
• Bae JH

• KMID: 2225775
• DOI: http://doi.org/10.4070/kcj.2008.38.6.295

Abstract

Chronic total occlusion (CTO) remains one of the most challenging lesion subsets for interventional cardiologists due to a low success rate and higher incidence of restenosis, especially with current use of bare metal stents (BMSs). However, successful CTO revascularization has a beneficial effect on long-term survival and relief of angina. With recent advances in technology (with the use of special techniques and devices), the initial success rate of recanalization of occlusions is quite high (approximately 90%). However, the long-term clinical outcome of the use of bare metal stents is not satisfactory due to a high restenosis rate. Recently, the introduction of the sirolimus-eluting stent (SES) and paclitaxel-eluting stent (PES) has shown favorable clinical outcomes, such as a reduction in the restenosis rate in patients with CTOs. Consequently, the use of the new types of stents can reduce the incidence of major adverse cardiac events detected at follow-up.

Keyword

Coronary occlusion; Angioplasty; Drug-Eluting stents

MeSH Terms

Angioplasty
Coronary Occlusion
Drug-Eluting Stents
Follow-Up Studies
Humans
Incidence
Stents

Figure

• 

  Fig. 1 Concept of the Retrograde Approach. A: the antegrade wire is unable to localize in the distal true lumen. B: the retrograde approach; the retrograde wire arrives from the distal collateral root to enter the CTO lesion. C: ballooning in a retrograde manner. D: re-wiring in an antegrade manner, followed by stenting. E: after stenting. CTO: chronic total occlusion.

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