Chronic total occlusions (CTO) are the most challenging lesions treated by interventional cardiologists. A symposium at EuroPCR 2014 discussed factors influencing the success of percutaneous intervention (PCI) in CTO. Current treatment paradigms suggest that one or two vessel disease should be treated by PCI while three-vessel disease requires surgery if complete revascularisation cannot be achieved with PCI. In patients with CTO and multi-vessel disease timing is key, and evidence of ischaemic burden and expected completeness of revascularisation is required before PCI is undertaken. Other factors affecting procedural success include the available equipment and expertise of the operator. Flexiblity in strategy selection is also important as it is frequently necessary to switch strategies during the procedure. The presentation included two live cases that illustrated the complexity of this procedure.
Heinz Joachim Büttner - Universitaets-Herzzentrum Freiburg, Bad Krozingen, Germany
Masahisa Yamane - Sayama Hospital, Saitama, Japan
Nicolaus Reifart - Department of Cardiology, Main Taunus Heart Institute, Bad Soden
Javier Escaned - Interventional Cardiology, Hospital Clinico San Carlos, Madrid, Spain
Georgios Sianos - 1st Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece
Omer Goktekin - Bezmialem Vakıf University, Istanbul, Turkey
Roberto Garbo - Ospedale San Giovanni Bosco, Torino, Italy
The publication of the article was supported by Alvimedica.