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Purpose of Review <p>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.</p> Recent Findings <p>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.</p> Summary <p>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.</p>

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Optimal Approach in Staged Chronic Total Occlusion Percutaneous Coronary Intervention

  • 期刊论文

  • 发表日期：

    2025年10月23日

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  • 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

摘要

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.