Key result
Drug-eluting stents reduce short- and mid-term restenosis and target lesion revascularization in chronic total occlusions, but are associated with emerging complications impacting long-term outcomes.
While drug-eluting stents reduce short- and mid-term restenosis in CTO recanalization, emerging long-term complications require careful consideration.
Supports short-term DES benefits in CTO but flags long-term risks; leaves open need for prospective safety trials.
Chronic total occlusion (CTO) is a common finding on diagnostic coronary angiography and constitutes one of the most challenging lesion subsets in interventional cardiology. The introduction of dedicated guidewires and the development of new techniques have improved the success rate in the crossing of CTO lesion while the use of bare-metal stents and drug-eluting stents has dramatically reduced the occurrence of restenosis and the need for target lesion revascularization in the short- and mid-term after CTO recanalization. However, new unsolved issues regarding the use of drug-eluting stents in CTO that might impact on long-term outcomes are emerging. The aim of this article is to review the current stage of knowledge on the application of stents in the treatment of CTO with a particular attention to the new complications associated with drug-eluting stent use in complex lesions.
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Leo et al. (2010) conducted a review in Chronic total coronary occlusions (CTO). Drug-eluting stents vs. Bare-metal stents was evaluated. Drug-eluting stents reduce short- and mid-term restenosis and target lesion revascularization in chronic total occlusions, but are associated with emerging complications impacting long-term outcomes.
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