Key result
Coronary collateral vessels in patients with chronic total occlusions prevent myocardial necrosis but are insufficient to prevent myocardial ischemia during exercise.
Why the study?
Does the presence of coronary collaterals provide sufficient protection against myocardial ischemia to negate the need for CTO revascularization?
Population
Patients with coronary artery disease and chronic total occlusions (CTOs)
Design
Review
Authors
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May warrant exercise ischemia monitoring in CTO despite collaterals; leaves open optimal revascularization thresholds.
Does the presence of coronary collaterals provide sufficient protection against myocardial ischemia to negate the need for CTO revascularization?
Coronary collaterals in CTOs prevent resting myocardial necrosis but are insufficient to prevent exercise-induced ischemia, challenging the belief that well-developed collaterals negate the need for CTO revascularization.
Vo et al. (2015) conducted a review in Chronic total occlusions (CTOs). Coronary collateral flow was evaluated. Coronary collateral vessels in patients with chronic total occlusions prevent myocardial necrosis but are insufficient to prevent myocardial ischemia during exercise.
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