Advances in techniques and specific training for CTO PCI have improved procedural success rates to approximately 90%, achieving outcomes comparable or superior to surgical revascularization.
Percutaneous coronary intervention for chronic total occlusions (CTOs), the most difficult and time-consuming intervention, is evolving rapidly. There has been a well-documented increase in the success rate of procedures in the hands of specifically trained operators from about 60 % to 90 % over the past 10 years; at the same time, the long-term patency with drug-eluting stents is exceeding 90 %. These results are comparable or even superior to surgical revascularisation. Several sophisticated techniques unique to CTO interventions are described in this article, and the need for specific training is emphasised so that a success rate of at least 80 % can be met, as claimed by the European Society of Cardiology guidelines on myocardial revascularisation, and so that patients with CTO who deserve revascularisation are no longer denied appropriate treatment.
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Nicolaus Reifart (2011) studied this question.
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