eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
Current issue Archive Manuscripts accepted About the journal Editorial board Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank
1/2021
vol. 17
 
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abstract:
Review paper

Chronic total occlusion percutaneous coronary intervention in everyday clinical practice – an expert opinion of the Association of Cardiovascular Interventions of the Polish Cardiac Society

Leszek Bryniarski
1
,
Maksymilian P. Opolski
2
,
Jarosław Wójcik
3
,
Maciej Lesiak
4
,
Tomasz Pawłowski
5
,
Jakub Drozd
6
,
Wojciech Wojakowski
7
,
Sławomir Surowiec
1
,
Maciej Dąbrowski
2
,
Adam Witkowski
2
,
Dariusz Dudek
1
,
Marek Grygier
4
,
Stanisław Bartuś
1

1.
Second Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
2.
Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland
3.
Hospital of Invasive Cardiology IKARDIA, Lublin/Nałęczów, Poland
4.
First Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
5.
Department of Invasive Cardiology, Centre of Postgraduate Medical Education, Warsaw, Poland
6.
Department of Cardiology, SP ZOZ MSWiA, Lublin, Poland
7.
Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
Adv Interv Cardiol 2021; 17, 1 (63): 6–20
Online publish date: 2021/03/27
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Coronary chronic total occlusions (CTO) are increasingly encountered during invasive and non-invasive coronary angiography and remain the most challenging lesions for percutaneous revascularization. During recent years success rates and safety outcomes of CTO percutaneous coronary intervention (PCI) have substantially improved, particularly due to the introduction of new techniques and dedicated equipment as well as specialized training programs of CTO operators. Significantly, the steady advances in CTO PCI techniques have coincided with the new data from randomized clinical trials supporting the role of percutaneous recanalization of CTO in relieving angina and improving the quality of life. The current expert consensus document outlines the rationale, clinical outcomes as well as technical, safety and reimbursement issues of CTO PCI. In addition, the requirements for achieving and maintaining competency in CTO PCI among interventional cardiologists are discussed. Finally, we present the modified hybrid algorithm (the so-called Polish hybrid algorithm) providing some unique refinements to the contemporary CTO PCI strategies. Continuous efforts (including active engagement with the payer) are urgently needed to increase guideline-recommended referrals to CTO PCI, and thus improve the quality of life of CTO patients in Poland.
keywords:

coronary chronic total occlusion, percutaneous coronary intervention, hybrid algorithm

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