Complex Angioplasty up to Chronic Total Occlusion*

One-year follow-up of myocardial perfusion and function evaluated by gated SPECT MIBI in patients with earlier myocardial infarction and chronic total occlusion

“…Patients with a CTO are most often managed surgically or with medication as compared to those without a CTO who usually undergo angioplasty [19,20]. Such management approach may be justified by the relatively limited overall success of recanalization, which is technically demanding and costly procedure with a high-radiation exposure [21]. In addition, Yousef and coworkers [6] found that the PCI 1 year after MI may result in significantly greater EDV and ESV compared with medical therapy alone, but with increased exercise tolerance and improved quality of life in the PCI group.…”

A Novel Penetration Device for Severe Stenosis or Chronic Total Occlusion in Coronary Artery Disease*

“…Reported success rates of CTO recanalization range from approximately 60% to 75% [4][5][6], and are much lower when compared with PCI of nontotal occlusions [7,8]. However, the same term is also used to describe total occlusions with TIMI grade 1 flow, the so-called functional occlusions with only faint, late anterograde flow [13]. The most common reasons for procedural failure include the inability of the guide wire to cross the occlusion (80-90%), the inability of the balloon to cross the oc-clusion (2-15%), and the inability to adequately dilate the lesion (2-5%) [10][11][12].…”