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Volume 110, Nº 5, Mes 2018


DOI: http://www.dx.doi.org/10.5935/abc.20180077


Percutaneous Coronary Intervention in Chronic Total Occlusion

Luiz Fernando Ybarra

Marcelo J. C. Cantarelli

Viviana M. G. Lemke

Alexandre Schaan de Quadros

Figure 2 – Hybrid Algorithm for Crossing Chronic Coronary Occlusions: The hybrid algorithm begins with double coronary injection (Item 1), which allows the evaluation of several angiographic parameters (Item 2) and selection of the type of primary approach: anterograde (Items 3 to 5) or retrograde (Item 6). Changes in strategy are performed (Item 7) depending on the evolution and progress of the procedure.


Percutaneous coronary intervention in chronic total occlusion is a rapidly evolving area, being considered the last frontier of interventional cardiology. In recent years, the development of new techniques and equipment, as well as the training of specialized personnel, increased their success rates, making it the most predictable procedure available. Although the number of randomized and controlled studies is still limited, results from large multicentered registries allow us to safely offer this intervention to patients, as another treatment option along with the optimized drug treatment and myocardial revascularization surgery. This review summarizes the last and most relevant publications in the subject in order to provide an overall view of the field’s current status.

Keywords: Coronary Artery Disease / complications; Coronary Occlusion; Percutaneous Coronary Intervention.