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Colombo et al. Vessel Plus 2019;3:29 Vessel Plus
DOI: 10.20517/2574-1209.2019.005

Review Open Access

Chronic total occlusion percutaneous coronary
intervention complications: prevention and

management

Francesco Colombo, Alessandro Bernardi, Roberto Garbo

Department of Cardiology, San Giovanni Bosco Hospital, Turin 10154, Italy.

Correspondence to: Dr. Francesco Colombo, Ospedale San Giovanni Bosco - Laboratorio di Interventistica Cardiovascolare,
Piazza del Donatore di Sangue 3, Turin, 10154, Italy. E-mail: francesco.colombo83@gmail.com
How to cite this article: Colombo F, Bernardi A, Garbo R. CTO PCI complications: prevention and management. Vessel Plus
2019;3:29. http://dx.doi.org/10.20517/2574-1209.2019.005
Received: 22 Jan 2019 First Decision: 17 Jun 2019 Revised: 18 Jun 2019 Accepted: 17 Jul 2019 Published: 9 Aug 2019

Science Editor: Boukhris Marouen Copy Editor: Jia-Jia Meng Production Editor: Jing Yu

Abstract
Received: First Decision: Revised: Accepted: Published: x
Percutaneous coronary intervention (PCI) of coronary chronic total occlusions (CTO) still represents a challenge
Science Editor: Copy Editor: Production Editor: Jing Yu
in the field of interventional cardiology. Despite the rate of peri-procedural complications has decreased over the
years, it remains higher than in non-CTO PCI. Coronary perforations are among the most common and serious
complications. Furthermore CTO recanalization carries a risk of unique and specific complications such as donor
vessel injury and equipment loss or entrapment. Other infrequent complications of non-CTO PCI such as contrast
induced renal dysfunction and radiation skin injury, assume more relevance in this subset given the length and
complexity of these procedures. Operators facing CTO percutaneous treatment should be aware of the potential
complications and the available strategies for prevention and management, to achieve procedural success.

Keywords: Chronic total occlusion; complications; coronary perforation; donor vessel injury; equipment entrapment

INTRODUCTION
Percutaneous coronary intervention (PCI) of coronary chronic total occlusions (CTO) still represents a
distinct challenge in the field of interventional cardiology. The rates of successful CTO recanalization
is growing, due to numerous advances in terms of newer dedicated devices, improved techniques and
extensive operators’ experience. Nevertheless coronary CTO treatment continues to be a challenging issue

© 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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