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The Evidence Base for Revascularisation of Chronic Total Occlusions
When patients with ischaemic heart disease are considered for revascularisation the Heart Team’s aim is to choose a therapy that will provide complete relief of angina for an acceptable procedural risk. Complete functional revascularisation of ischaemic myocardium is thus the goal and for this reaso...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Bentham Science Publishers
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4021288/ https://www.ncbi.nlm.nih.gov/pubmed/24694105 http://dx.doi.org/10.2174/1573403X10666140331125659 |
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author | Bagnall, Alan Spyridopoulos, Ioakim |
author_facet | Bagnall, Alan Spyridopoulos, Ioakim |
author_sort | Bagnall, Alan |
collection | PubMed |
description | When patients with ischaemic heart disease are considered for revascularisation the Heart Team’s aim is to choose a therapy that will provide complete relief of angina for an acceptable procedural risk. Complete functional revascularisation of ischaemic myocardium is thus the goal and for this reason the presence of a chronic total occlusion (CTO) - which remain the most technically challenging lesions to revascularise percutaneously - is the most common reason for selecting coronary artery bypass surgery [1]. From the behaviour of Heart Teams it is clear that physicians believe that CTOs are important. Yet when faced with patients with CTOs for whom surgery appears excessive (e.g. nonproximal LAD) or too high risk, there remains a reluctance to undertake CTO PCI, despite significant recent advances in procedural success and safety and a considerable body of evidence supporting a survival benefit following successful CTO PCI. This article reviews the relationship between CTOs, symptoms of angina, ischaemia and left ventricular dysfunction and further explores the evidence relating their treatment to improved quality of life and prognosis in patients with these features. |
format | Online Article Text |
id | pubmed-4021288 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Bentham Science Publishers |
record_format | MEDLINE/PubMed |
spelling | pubmed-40212882015-05-01 The Evidence Base for Revascularisation of Chronic Total Occlusions Bagnall, Alan Spyridopoulos, Ioakim Curr Cardiol Rev Article When patients with ischaemic heart disease are considered for revascularisation the Heart Team’s aim is to choose a therapy that will provide complete relief of angina for an acceptable procedural risk. Complete functional revascularisation of ischaemic myocardium is thus the goal and for this reason the presence of a chronic total occlusion (CTO) - which remain the most technically challenging lesions to revascularise percutaneously - is the most common reason for selecting coronary artery bypass surgery [1]. From the behaviour of Heart Teams it is clear that physicians believe that CTOs are important. Yet when faced with patients with CTOs for whom surgery appears excessive (e.g. nonproximal LAD) or too high risk, there remains a reluctance to undertake CTO PCI, despite significant recent advances in procedural success and safety and a considerable body of evidence supporting a survival benefit following successful CTO PCI. This article reviews the relationship between CTOs, symptoms of angina, ischaemia and left ventricular dysfunction and further explores the evidence relating their treatment to improved quality of life and prognosis in patients with these features. Bentham Science Publishers 2014-05 2014-05 /pmc/articles/PMC4021288/ /pubmed/24694105 http://dx.doi.org/10.2174/1573403X10666140331125659 Text en © 2014 Bentham Science Publishers http://creativecommons.org/licenses/by/2.5/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/), which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Article Bagnall, Alan Spyridopoulos, Ioakim The Evidence Base for Revascularisation of Chronic Total Occlusions |
title | The Evidence Base for Revascularisation of Chronic Total Occlusions |
title_full | The Evidence Base for Revascularisation of Chronic Total Occlusions |
title_fullStr | The Evidence Base for Revascularisation of Chronic Total Occlusions |
title_full_unstemmed | The Evidence Base for Revascularisation of Chronic Total Occlusions |
title_short | The Evidence Base for Revascularisation of Chronic Total Occlusions |
title_sort | evidence base for revascularisation of chronic total occlusions |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4021288/ https://www.ncbi.nlm.nih.gov/pubmed/24694105 http://dx.doi.org/10.2174/1573403X10666140331125659 |
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