Appropriateness of percutaneous revascularization of coronary chronic total occlusions: An overview

Alfredo R. Galassi, Emmanouil S. Brilakis, Marouane Boukhris, Salvatore D. Tomasello, Georgios Sianos, Dimitri Karmpaliotis, Carlo Di Mario, Bradley H. Strauss, Stephane Rinfret, Masahisa Yamane, Osamu Katoh, Gerald S. Werner, Nicolaus Reifart

Research output: Contribution to journalReview articlepeer-review

80 Scopus citations


Coronary chronic total occlusions (CTOs) are commonly encountered in patients undergoing coronary angiography. Several observational studies have demonstrated that successful CTO revascularization is associated with better cardiovascular outcomes and enhanced quality of life (QOL). However, in the absence of randomized trials, its prognostic benefit for patients remains debated. Over the past decade, the interest of the interventional community in CTO percutaneous coronary intervention (PCI) has exponentially grown due to important developments in dedicated equipment and techniques, resulting in high success and low complication rates. Both European and American guidelines have assigned a class IIa (level of evidence B) recommendation for CTO PCI. In the current review, we focus on the impact of CTO revascularization on clinical outcomes and QOL and on appropriate patient selection, and we provide a critical assessment of the current guidelines and recommendations on CTO PCI.

Original languageEnglish (US)
Pages (from-to)2692-2700
Number of pages9
JournalEuropean heart journal
Issue number35
StatePublished - Sep 14 2016


  • Cardiovascular outcome
  • Chronic total occlusion
  • Guidelines
  • PCI
  • Quality of life

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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