Author + information
- Received November 30, 2010
- Revision received June 15, 2011
- Accepted June 23, 2011
- Published online September 1, 2011.
- Satoru Sumitsuji, MD⁎,⁎ (, )
- Katsumi Inoue, MD†,
- Masahiko Ochiai, MD‡,
- Etsuo Tsuchikane, MD§ and
- Fumiaki Ikeno, MD∥
- ↵⁎Reprint requests and correspondence
: Dr. Satoru Sumitsuji, Osaka University, Department of Cardiology, Nozaki Tokushukai Hospital/Nagoya Tokushukai General Hospital, Bio-L2 Advanced Cardiovascular Therapeutics, Osaka University, 2-2 Yamadaoka Suita, Osaka, 565-0871 Japan
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.
Dr. Sumitsuji has served on the Speakers' Bureau for Abbott Vascular, Asahi Intec, Biosensors, Johnson & Johnson (Cordis), and Terumo; and as consultant to Goodman and Zio Software. Dr. Ochiai has served on the Speakers' Bureau for Abbott Vascular, Asahi Intecc, Boston Scientific, and Terumo. Dr. Tsuchikane has served on the Speakers' Bureau for Asahi Intecc, Abbott Vascular, Boston Scientific, and Johnson & Johnson (Cordis). Dr. Ikeno has served as consultant to Asahi Intecc and Terumo. Dr. Inoue has reported that he has no relationships relevant to the contents of this paper to disclose.
- Received November 30, 2010.
- Revision received June 15, 2011.
- Accepted June 23, 2011.
- American College of Cardiology Foundation