Advances in the management of coronary chronic total occlusions

Emmanouil S. Brilakis, Dimitri Karmpaliotis, Minh N. Vo, Santiago Garcia, Lampros Michalis, Khaldoon Alaswad, Parag Doshi, William L. Lombardi, Subhash Banerjee

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Chronic total occlusions (CTOs) have been called "the last frontier" of percutaneous coronary intervention (PCI) due to traditionally low success rates and high risk for restenosis and re-occlusion. Recent advances in equipment and crossing techniques have significantly increased CTO PCI success rates while maintaining low risk of complications. Specifically, the retrograde approach and controlled antegrade dissection and re-entry in conjunction with advanced guidewires and microcatheters have significantly improved procedural success rates. Moreover, the introduction of the "hybrid" approach has created a unified framework for operators to approach CTOs in a systematic and efficient fashion. Finally, drug-eluting stents, especially second generation, have improved long-term patency after CTO PCI.

Original languageEnglish (US)
Pages (from-to)426-436
Number of pages11
JournalJournal of cardiovascular translational research
Issue number4
StatePublished - Jun 2014


  • Chronic total occlusion
  • Coronary revascularization
  • Percutaneous coronary intervention

ASJC Scopus subject areas

  • Molecular Medicine
  • Genetics
  • Pharmaceutical Science
  • Cardiology and Cardiovascular Medicine
  • Genetics(clinical)


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