Percutaneous interventional strategies in the treatment of chronic total coronary occlusions.
Chronic total coronary occlusions which make up 10% to 20% of all interventional procedures in high-volume centres remain a vexing problem for invasive cardiologists for 2 main reasons. First, they are only successfully recanalised in about 60% of attempts with most failures resulting from an inability to cross the lesions. Laser guidewire appears to be a promising innovation in overcoming this obstacle. Second, after initially successful recanalisation with conventional balloon angioplasty (PTCA), a high restenosis rate (range, 45% to 75%) is observed. Stent placement, by conferring maximal luminal expansion, appears to have resolved this problem to a large extent; both observational and randomised studies indicate that after stent placement, restenosis rate is at least halved that of PTCA.
Lau
K W
KW
National Heart Centre, 3rd Hospital Avenue, Singapore 168752.
Ding
Z P
ZP
Sigwart
U
U
Lam
L
L
D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000628:therapy*; D006801:Humans; D011379:Prognosis; D012008:Recurrence; D015607:Stents