Chronic Total Occlusion (CTO)


Abstract: Background. Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has significantly evolved in recent years.

We retrospectively evaluated procedural and clinical outcomes in consecutive patients undergoing Tandem Heart assisted CTO-PCI at our institution.
We report a case of RA-induced fistula between the diagonal branch and the accompanying vein. Thus far, the patient has had no relevant symptoms; thus, no intervention has been undertaken. We will closely monitor the patient to determine future treatment.
CTO-PCI often requires administration of large contrast volume. The DyeVert system (Osprey Medical, Inc) is a device that interfaces with standard manifold systems to reduce the amount of contrast used. We compared the procedural outcomes of patients with vs without the DyeVery system.
Review of 4436 CTO-PCIs performed in 4340 patients between 2012 and 2018 at 25 sites produced 20 LMCA cases; we examined the clinical and angiographic characteristics and procedural outcomes of each case.