Journal article
A Review of Indications and Guidelines of Chronic Total Occlusion Revascularization
The International journal of angiology, Vol.34(4), pp.354-359
12/2025
DOI: 10.1055/a-2655-2536
PMCID: PMC12591710
PMID: 41210666
Abstract
Chronic total occlusion (CTO), affecting 18 to 30% of coronary artery disease patients undergoing angiography, is linked to refractory angina, reduced left ventricular function, and increased arrhythmia risk. This article synthesizes indications, evidence, and guidelines for CTO revascularization, focusing on percutaneous coronary intervention (PCI). CTO PCI achieves over 85% success rates in expert hands, with randomized controlled trials showing improved symptom relief and quality of life, though mortality or ventricular function benefits remain unproven. The 2021 ACC/AHA/SCAI and 2018 ESC/EACTS guidelines recommend CTO PCI for refractory angina, emphasizing operator expertise and shared decision-making. Controversies persist regarding prognostic benefits and patient selection. Ongoing trials aim to clarify these issues. This review equips clinicians with a framework to navigate CTO management, balancing evidence and patient-centered care.
Details
- Title: Subtitle
- A Review of Indications and Guidelines of Chronic Total Occlusion Revascularization
- Creators
- Spas Kotev - University of IowaFarhad Sami - University of Iowa Health CareBoniface Malangu - University of Iowa Health Care
- Resource Type
- Journal article
- Publication Details
- The International journal of angiology, Vol.34(4), pp.354-359
- DOI
- 10.1055/a-2655-2536
- PMID
- 41210666
- PMCID
- PMC12591710
- NLM abbreviation
- Int J Angiol
- ISSN
- 1061-1711
- eISSN
- 1615-5939
- Publisher
- Thieme Medical Publishers
- Number of pages
- 6
- Language
- English
- Electronic publication date
- 08/04/2025
- Date published
- 12/2025
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984966854702771
Metrics
8 Record Views