alexa Fundamental wire technique and current standard strategy of percutaneous intervention for chronic total occlusion with histopathological insights.
Surgery

Surgery

Journal of Vascular Medicine & Surgery

Author(s): Sumitsuji S, Inoue K, Ochiai M, Tsuchikane E, Ikeno F

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Abstract Currently, successful treatment of chronic total occlusion (CTO) seems markedly improved, due to several new techniques and dedicated device developments. However, this improved success rate is often limited to procedures performed by skilled, highly experienced operators. To improve the overall success rate of percutaneous coronary intervention of CTO from a worldwide perspective, a deeper understanding of CTO histopathology might offer insights into the development of new techniques and procedural strategies. In this review, CTO histopathology and wire techniques are discussed on the basis of the fundamental concepts of antegrade and retrograde approaches. Although details pertaining to wire manipulation are very difficult to explain objectively, we tried to describe this as best as possible in this article. Finally, a systematic review of the current standard CTO strategy is provided. Hopefully, this article will enhance the understanding of this complex procedure and, consequently, promote safe and effective CTO-percutaneous coronary intervention for patients who present with this challenging lesion subset. Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. This article was published in JACC Cardiovasc Interv and referenced in Journal of Vascular Medicine & Surgery

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