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Minerva Cardiology and Angiology 2021 December;69(6):773-86

DOI: 10.23736/S2724-5683.21.05831-2

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Complications during chronic total occlusion percutaneous coronary intervention: a sign- and symptom-based approach to early diagnosis and treatment

Francesco MORONI 1, 2, Ricardo SANTIAGO 3, Riccardo DI PIETRO 4, Simone CALCAGNO 4, Lorenzo AZZALINI 1

1 Division of Cardiology, VCU Health Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA; 2 IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy; 3 PCI Cardiology Group and Bayamon Heart and Lung Institute, Bayamon, PR, USA; 4 Unit of Interventional Cardiology, SM Goretti Hospital, Latina, Italy



Coronary chronic total occlusions (CTO) are frequently found in patients undergoing coronary angiography. Despite their high prevalence and indication for revascularization in a relevant proportion of cases, CTO recanalization is attempted only in a minority of cases. This is due to higher risk of procedural complications compared to non-CTO interventions and because CTO-PCIs are the most complex procedures in interventional cardiology. In particular, the perceived higher risk of complications during CTO interventions might discourage new operators from engaging in this challenging field. The aim of this work was to review the potential complications of CTO percutaneous coronary intervention, and to provide an algorithmic, sign- and symptom-based approach to facilitate early recognition and effective management.


KEY WORDS: Percutaneous coronary intevention; Coronary occlusion; Coronary artery disease

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