Percutaneous revascularisation of a coronary chronic total occlusion (CTO) remains one of the technical frontiers of interventional cardiology. CTOs are common, and yet intervention is only attempted in 10 % of cases. CTO procedures are perceived to be technically challenging, lengthy, associated with significant risk and have only limited data to support the practise. Recent technical advances have dramatically increased the success rate, shortened procedural time and improved clinical outcomes. The aim of this article is to critically examine the data that supports CTO intervention, including specifically an appraisal of procedural safety, benefit and overall cost effectiveness.
John Rawlins - Wessex Cardiothoracic Centre, University Hospital Southampton NHS Trust
James Wilkinson - Wessex Cardiothoracic Centre, University Hospital Southampton NHS Trust
Nick Curzen - Wessex Cardiothoracic Centre, University Hospital Southampton NHS Trust; 2. Faculty of Medicine, University of Southampton