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Current Cardiology Reports

Optimal Approach in Staged Chronic Total Occlusion Percutaneous Coronary Intervention

Published in:
Authors
Sandeep Jalli
Dimitrios Strepkos
Michaella Alexandrou
Deniz Mutlu
Pedro E. P. Carvalho
Eleni Kladou
Ozgur S. Ser
Jaskanwal Deep Singh Sara
Olga Mastrodemos
Bavana V. Rangan
Konstantinos Voudris
M. Nicholas Burke
Yader Sandoval
Emmanouil S. Brilakis
Published in
Current Cardiology Reports | Issue 1/2025

Abstract

Purpose of Review

To discuss the optimal timing of staged chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in patients presenting with acute coronary syndromes (ACS), multiple CTOs and after a CTO modification procedure.

Recent Findings

In patients with acute coronary syndromes CTO PCI should be performed as part of a complete revascularization strategy within a few weeks or months from the initial presentation. In patients who undergo CTO modification procedures, such as subintimal tracking and re-entry (STAR) earlier re-intervention (within 1–2 months) is better than later re-intervention. Staged intervention is preferred in most patients who need PCI of more than one CTO to minimize the risk of complications.

Summary

The optimal timing of CTO intervention as part of a complete revascularization strategy remains unknown, as does the optimal timing of repeat intervention after a CTO modification procedure, though earlier is likely better than later in both cases. PCI of more than one CTO in the same patient should also be staged for safety reasons.
Title
Optimal Approach in Staged Chronic Total Occlusion Percutaneous Coronary Intervention
Authors
Sandeep Jalli
Dimitrios Strepkos
Michaella Alexandrou
Deniz Mutlu
Pedro E. P. Carvalho
Eleni Kladou
Ozgur S. Ser
Jaskanwal Deep Singh Sara
Olga Mastrodemos
Bavana V. Rangan
Konstantinos Voudris
M. Nicholas Burke
Yader Sandoval
Emmanouil S. Brilakis
Publication date
01-12-2025
Publisher
Springer US
Published in
Current Cardiology Reports / Issue 1/2025
Print ISSN: 1523-3782
Electronic ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-025-02318-4
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This content is intended for healthcare professionals outside of the UK.

Independent Medical Education Grant:
  • Bayer HealthCare Pharmaceuticals Inc.
Learn more Link opens in a new window
Image Credits
Abstract graphic of layered, concentric circular shapes in bright green, pink, blue, and purple on a dark blue background. The rings and segments form a complex radial pattern without text/© Springer Health+ IME