title: Percutaneous interventional strategies in the treatment of chronic total coronary occlusions.
abstract: 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.
authors.affiliation: National Heart Centre, 3rd Hospital Avenue, Singapore 168752.
authors.forename: K W
authors.initials: KW
authors.lastname: Lau
authors.forename: Z P
authors.initials: ZP
authors.lastname: Ding
authors.forename: U
authors.initials: U
authors.lastname: Sigwart
authors.forename: L
authors.initials: L
authors.lastname: Lam
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000628:therapy*; D006801:Humans; D011379:Prognosis; D012008:Recurrence; D015607:Stents