Gaining a better insight in chronic total occlusions, procedure data and clinical outcome

Abstract

Lesion characteristics of chronic total occlusions (CTOs) have been shown to have a negative influence on guidewire (GW) crossing and procedural outcome, resulting in suboptimal success rates (70-80%). A large range of dedicated CTO GWs and complex techniques has been developed to improve these success rates. However, less experienced operators can become confused by this abundant choice of GWs and will be reluctant to apply these complex percutaneous coronary intervention (PCI) techniques. Therefore, the benefit of a simple antegrade step-up algorithm, with a pre-defined set of GWs, was investigated (part 1). Besides this, a clear description of the individual impact of these CTO characteristics is lacking. Therefore, it was tried to give a 'weight' to these individual characteristics and evaluate their influence on PCI outcome, procedural characteristics and interventional treatment strategy (part 2).