Treatment of the chronic total occlusion: A call to action for the interventional community

Mauro Carlino, Caroline J. Magri, Barry F. Uretsky, Emmanouil S. Brilakis, Simon Walsh, James C. Spratt, Colm Hanratty, J. Aaron Grantham, Stéphane Rinfret, Craig A. Thompson, William L. Lombardi, Alfredo R. Galassi, George Sianos, Azeem Latib, Roberto Garbo, Dimitri Karmpaliotis, David E. Kandzari, Antonio Colombo

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


There is substantial evidence that recanalization of a chronic total occlusion is beneficial; nonetheless, it is generally underutilized in clinical practice. We consider the Aesop's fable of the "Fox and the Grapes" as analogous to the current situation in interventional cardiology. The technical challenges in achieving CTO recanalization has led interventionalists, clinical cardiologists, and sometimes even patients to believe that CTO recanalization is not effective, and, therefore, not needed. This perspective reviews available data regarding efficacy and safety of CTO percutaneous coronary intervention (PCI) in the current drug-eluting stent era, discusses areas where more studies are required, and encourages the interventional community to utilize CTO PCI where appropriate based on current evidence.

Original languageEnglish (US)
Pages (from-to)771-778
Number of pages8
JournalCatheterization and Cardiovascular Interventions
Issue number5
StatePublished - Apr 1 2015


  • chronic total occlusions
  • coronary artery bypass grafting
  • coronary artery disease
  • myocardial infarction
  • percutaneous coronary intervention

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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