Chronic total occlusion recanalization

More recent series have also documented a survival advantage (7-9). Hoye et al. in 874 consecutive patients with a CTO found a five-year survival in 93.5% of patients with successful revascularization versus 88.0% in these patients with failed revascularization (p = 0.02). In a Canadian registry of 1458 patients at seven year, successful recanalization of a chronic total occlusion was associated with improved survival as well as lower rates of PCI and/or CABG (9). In addition to survival advantage, both regional and global left ventricular function is improved in patients with successful treatment of a chronic total occlusion (10). This improvement may depend on whether the patient had a prior infarction in the distribution of the occlusion (II). If prior infarction resulted in frank myocardial necrosis, then recanalization may not improve the function however, many patients with chronic occlusion have preservation of regional wall function. 

Dynamic wave registry of four separate time intervals. Attempts at CTO recanalization have been decreased. Abbreviation CTO, chronic total occlusion. 

I I Chung CM, Nakamura S, Tanaka K, et al. Effect of recanalization of chronic total occlusions on global and regional left ventricular function in patients with or without previous myocardial infarctions. Catheter Cardiovasc Interv2003 60 368-374. 

Abbas AE, Brewington SD, Dixon SR, et al. Intracoronary fibrin-specific thrombolytic infusion facilitates percutaneous recanalization of chronic total occlusion. JACC 2005 46 793-798. 

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