title: Appropriateness of percutaneous revascularization of coronary chronic total occlusions: an overview.
abstract: Coronary chronic total occlusions (CTOs) are commonly encountered in patients undergoing coronary angiography. Several observational studies have demonstrated that successful CTO revascularization is associated with better cardiovascular outcomes and enhanced quality of life (QOL). However, in the absence of randomized trials, its prognostic benefit for patients remains debated. Over the past decade, the interest of the interventional community in CTO percutaneous coronary intervention (PCI) has exponentially grown due to important developments in dedicated equipment and techniques, resulting in high success and low complication rates. Both European and American guidelines have assigned a class IIa (level of evidence B) recommendation for CTO PCI. In the current review, we focus on the impact of CTO revascularization on clinical outcomes and QOL and on appropriate patient selection, and we provide a critical assessment of the current guidelines and recommendations on CTO PCI.
authors.affiliation: Department of Clinical and Experimental Medicine, Catheterization Laboratory and Cardiovascular Interventional Unit, Cannizzaro Hospital, University of Catania, Via Antonello da Messina 75, Acicastello, 95021 Catania, Italy argalassi@gmail.com.
authors.forename: Alfredo R
authors.initials: AR
authors.lastname: Galassi
authors.affiliation: Veterans Administration North Texas Healthcare System and University of Texas Southwestern Medical School, Dallas, TX, USA.
authors.forename: Emmanouil S
authors.initials: ES
authors.lastname: Brilakis
authors.affiliation: Department of Clinical and Experimental Medicine, Catheterization Laboratory and Cardiovascular Interventional Unit, Cannizzaro Hospital, University of Catania, Via Antonello da Messina 75, Acicastello, 95021 Catania, Italy Faculty of Medicine of Tunis, University of Tunis El Manar, El Manar, Tunisia.
authors.forename: Marouane
authors.initials: M
authors.lastname: Boukhris
authors.affiliation: Department of Clinical and Experimental Medicine, Catheterization Laboratory and Cardiovascular Interventional Unit, Cannizzaro Hospital, University of Catania, Via Antonello da Messina 75, Acicastello, 95021 Catania, Italy.
authors.forename: Salvatore D
authors.initials: SD
authors.lastname: Tomasello
authors.affiliation: Department of Cardiology, American Hellenic Educational Progressive Association University Hospital, Thessaloniki, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Sianos
authors.affiliation: Columbia University, New York, NY, USA.
authors.forename: Dimitri
authors.initials: D
authors.lastname: Karmpaliotis
authors.affiliation: NIHR Cardiovascular BRU Royal Brompton Hospital & National Heart and Lung Institute, Imperial College London, London, UK.
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Mario
authors.affiliation: Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
authors.forename: Bradley H
authors.initials: BH
authors.lastname: Strauss
authors.affiliation: Cardiology Department, Quebec Heart and Lung Institute, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC, Canada.
authors.forename: Stephane
authors.initials: S
authors.lastname: Rinfret
authors.affiliation: Department of Cardiology, Sayama Hospital, Saitama, Japan.
authors.forename: Masahisa
authors.initials: M
authors.lastname: Yamane
authors.affiliation: Department of Cardiology, Toyohashi Heart Center, Aichi, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Katoh
authors.affiliation: Medizinische Klinik I (Cardiology and Intensive Care), Klinikum Darmstadt GmbH, Darmstadt, Germany.
authors.forename: Gerald S
authors.initials: GS
authors.lastname: Werner
authors.affiliation: Department of Cardiology, Main Taunus Hospitals, Bad Soden University of Frankfurt, Frankfurt, Germany.
authors.forename: Nicolaus
authors.initials: N
authors.lastname: Reifart
mesh_terms: D002908:Chronic Disease; D054059:Coronary Occlusion; D006801:Humans; D062645:Percutaneous Coronary Intervention; D011788:Quality of Life; D016896:Treatment Outcome
keywords: Cardiovascular outcome; Chronic total occlusion; Guidelines; PCI; Quality of life