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Paraggio et al. Vessel Plus 2019;3:12 Vessel Plus
DOI: 10.20517/2574-1209.2018.72

Review Open Access

Usefulness of chronic total occlusion devices and
techniques in other complex lesion subsets

Lazzaro Paraggio, Francesco Burzotta, Cristina Aurigemma, Carlo Trani

Institute of Cardiology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome
00168, Italy.

Correspondence to: Dr. Francesco Burzotta, Institute of Cardiology, Università Cattolica del Sacro Cuore, Fondazione Policlinico
Universitario A. Gemelli, IRCCS, Rome 00168, Italy. E-mail: francescoburzotta@gmail.com

How to cite this article: Paraggio L, Burzotta F, Aurigemma C, Trani C. Usefulness of chronic total occlusion devices and
techniques in other complex lesion subsets. Vessel Plus 2019;3:12. http://dx.doi.org/10.20517/2574-1209.2018.72

Received: 9 Nov 2018 First Decision: 21 Jan 2019 Revised: 11 Feb 2019 Accepted: 12 Mar 2019 Published: 19 Apr 2019

Science Editors: Alfredo R. Galassi, Marouane Boukhris Copy Editor: Cai-Hong Wang Production Editor: Huan-Liang Wu

Abstract
Percutaneous coronary interventions (PCI) in chronic total occlusion (CTO) have been for long time considered as “last
frontier” in interventional cardiology. Among the different subset of complex targets for PCI, CTO lesions represent a
challenge for the interventional cardiologist. CTO techniques and devices have evolved in last few years together with
the training of specialized interventional cardiologist in such complex field. All these factors have markedly increased
procedural success of CTO procedures and have the potential to be applied in other settings. In this paper, we provide an
update on the technical aspects and the devices developed for CTO PCIs that can be applied in complex PCI on non-CTO
lesions.

Keywords: Chronic total occlusion, complex percutaneous coronary interventions, complications, interventional devices

INTRODUCTION
Chronic total occlusion (CTO) lesions are defined as a coronary lesion with Thrombolysis In Myocardial
Infarction grade 0 flow distal to the occluded segment and, although often difficult to determine, clinical
[1]
evidence of occlusion duration more than 3 months .

CTO represent the most technically challenging procedure subset for the interventional cardiologists.
They show a high prevalence between patients referred for coronary angiography in various real-world
[2,3]
registries, with an incidence increasing with age . Some recent observational studies have shed a new

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
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sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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and indicate if changes were made.

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