Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Feb 21;21(2):9.
doi: 10.1007/s11886-019-1091-2.

Percutaneous Coronary Intervention of Chronic Total Occlusions in Patients with Diabetes Mellitus: a Treatment-Risk Paradox

Juan F Iglesias  1 , Sophie Degrauwe  1 , Fabio Rigamonti  1 , Stéphane Noble  1 , Marco Roffi  2
Affiliations
Review

Percutaneous Coronary Intervention of Chronic Total Occlusions in Patients with Diabetes Mellitus: a Treatment-Risk Paradox

Juan F Iglesias et al. Curr Cardiol Rep. .

Abstract

Purpose of review: Diabetes mellitus (DM) is highly prevalent among patients undergoing percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs). This review aims to summarize the available evidence on CTO recanalization in patients with DM.

Recent findings: Coronary artery bypass grafting (CABG) surgery is the recommended revascularization modality for patients with DM and multivessel coronary artery disease (CAD). However, the optimal management strategy in diabetic patients with CTO and single-vessel disease or prior CABG remains a clinical dilemma. Contemporary, large-scale, observational registries support the notion that CTO PCI, if performed at high-volume CTO PCI centers by highly experienced operators, conveys similar high procedural success and low complication rates in patients with and without DM. Although DM patients have more frequently CTOs and may derive greater benefit from complete revascularization, they are less frequently exposed to CTO PCI than non-DM patients (treatment-risk paradox). CTO PCI performed by highly experienced operators constitutes a safe and effective treatment option for selected diabetic CTO patients who are not candidates for CABG. Randomized studies are warranted to compare long-term outcomes of CTO PCI and medical therapy in this high-risk subset.

Keywords: Chronic total occlusion; Coronary revascularization; Diabetes mellitus; Percutaneous coronary intervention.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. JACC Cardiovasc Interv. 2018 Apr 9;11(7):615-625 - PubMed
    1. Catheter Cardiovasc Interv. 2016 Jan 1;87(1):3-12 - PubMed
    1. J Am Coll Cardiol. 2013 Oct 15;62(16):1421-31 - PubMed
    1. J Cardiovasc Thorac Res. 2011;3(2):45-8 - PubMed
    1. Am J Cardiol. 2015 Dec 1;116(11):1774-80 - PubMed