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Review
. 2024 Feb 6:11:1350549.
doi: 10.3389/fcvm.2024.1350549. eCollection 2024.

A non-interventional cardiologist's guide to coronary chronic total occlusions

Lindsey Cilia  1   2 , Michael Megaly  3 , Rhian Davies  4 , Behnam N Tehrani  2 , Wayne B Batchelor  2 , Alexander G Truesdell  1   2
Affiliations
Review

A non-interventional cardiologist's guide to coronary chronic total occlusions

Lindsey Cilia et al. Front Cardiovasc Med. .

Abstract

Coronary chronic total occlusions (CTO) are present in up to one-third of patients with coronary artery disease (CAD). It is thus essential for all clinical cardiologists to possess a basic awareness and understanding of CTOs, including optimal evaluation and management. While percutaneous coronary intervention (PCI) for CTO lesions has many similarities to non-CTO PCI, there are important considerations pertaining to pre-procedural evaluation, interventional techniques, procedural complications, and post-procedure management and follow-up unique to patients undergoing this highly specialized intervention. Distinct from other existing topical reviews, the current manuscript focuses on key knowledge relevant to non-interventional cardiologists.

Keywords: CABG; chronic total occlusions; coronary artery disease; percutaneous coronary intervention; revascularization; total coronary occlusion.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Indications for CTO PCI. Potential indications for CTO PCI primarily include: relief of angina, improvement in left ventricular systolic function, reduction of ischemia burden, prevention of “double jeopardy” in acute coronary syndrome, and complete revascularization.
Figure 2
Figure 2
CTO PCI program referral recommendations. Evaluation and management of CTOs varies based on medical specialty and includes: assessment of angina and ischemia, review of patient comorbidities and values, maximization of medical therapy, referral to a CTO specialist, and consideration of PCI.
See this image and copyright information in PMC

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The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.