Antegrade dissection/reentry is a safe and efficient strategy for crossing long chronic total occlusions (CTOs), as outlined in the hybrid CTO crossing algorithm ( Chapter 7 ). Antegrade dissection takes advantage of the distensibility of the subintimal space for traversing…
Antegrade wire escalation is the simplest and most widely used chronic total occlusion (CTO) crossing technique. At least 50% of CTO interventions are currently successfully recanalized using antegrade wire escalation. Familiarity and confidence with this technique provides the foundation upon…
3.1 Timing In general, chronic total occlusion (CTO) percutaneous coronary interventions (PCIs) should not be performed ad hoc in order to : a. Allow time for thorough procedural planning and preparation for both the operator and the cardiac catheterization laboratory…
2.1 Introduction One of the most frequently asked questions about chronic total occlusion (CTO) percutaneous coronary intervention (PCI), especially from programs early in the learning curve, is, “what equipment do I really need?” Although many operators would like to have…
1.1 Chronic Total Occlusion Definition A coronary chronic total occlusion (CTO) is defined as 100% occlusion in a coronary artery with noncollateral thrombolysis in myocardial infarction (TIMI) 0 flow of at least 3 month duration. The duration of occlusion may…