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Abstract: This paper describes the current status of percutaneous coronary intervention (PCI) for totally occluded coronary arteries. chronic total occlusion is associated with 10%–20% of all PCI procedures. Results show that opening an occluded vessel, especially one supplying a considerable area of myocardium, may be beneficial for a patient’s angina relief and heart function. We describe the devices used currently in re-canalization such as new wires, microcatheters (including Tonus and Cosair) and intravascular ultrasound guidance. Different techniques to improve the success rate and reduce complications are discussed in detail.

[1]Abhaichand, R.K., Lefèvre, T., Louvard, Y., Morice, M.C., 2001. Amplatzing a 6 Fr Judkins right guiding catheter for increased success in complex right coronary artery anatomy. Catheter Cardiovasc. Interv., 53(3):405-409.

[2]di Mario, C., Werner, G.S., Sianos, G., Galassi, A.R., Büttner, J., Dudek, D., Chevalier, B., Lefevre, T., Schofer, J., Koolen, J., et al., 2007. European perspective in the recanalisation of chronic total occlusions (CTO): consensus document from the EuroCTO Club. EuroIntervention, 3(1):30-43.

[3]Freed, M.S., Safian, R.D., 2001. Chronic Total Occlusion. In: Safian, R.D., Freed, M.S. (Eds.), The Manual of Interventional Cardiology, 3rd Ed. Physicians’ Press, Royal Oak, Mich., p.287-299.

[4]Fujita, S., Tamai, H., Kyo, E., Kosuga, K., Hata, T., Okada, M., Nakamura, T., Tsuji, T., Takeda, S., Bin Hu, F., et al., 2003. New technique for superior guiding catheter support during advancement of a balloon in coronary angioplasty: the anchor technique. Catheter Cardiovasc. Interv., 59(4):482-488.

[5]Ge, J.B., Zhang, F., 2009. Retrograde recanalization of chronic total coronary artery occlusion using a novel “reverse wire trapping” technique. Catheter Carciovasc. Interv., 74(6):855-860.

[6]Ge, J.B., Ge, L., Qian, J.Y., Liu, X.B., Wang, H., Zhang, F., Zhang, S.H., 2006. Retrograde wire technique for recanalization of a left main chronic total occlusion. Chin. J. Intervent. Cardiol., 14(1):55-56 (in Chinese).

[7]Ge, J.B., Huang, D., Zhang, F., Qian, J.Y., Ge, L., Wang, Q.B., 2008a. Clinical experience of a novel penetration Tornus catheter in percutaneous treatment of coronary chronic total occlusion lesions. Chin. J. Intervent. Cardiol., 16(4):184-186 (in Chinese).

[8]Ge, J.B., Zhang, F., Ge, L., Qian, J.Y., Wang, H., 2008b. Wire trapping tachnoque combined with retrograde approach for recanalization of chronic total occlusion. Chin. Med. J. (Engl.), 121(17):1753-1756.

[9]Hamood, H., Makhoul, N., Grenadir, E., Kusniec, F., Rosenschein, U., 2006. Anchor wire technique improves device deliverability during PCI of CTOs and other complex subsets. Acute Card. Care, 8(3):139-142.

[10]Han, Y.L., Li, Y., Wang, S.L., Jing, Q.M., Ma, Y.Y., Wang, G., Luan, B., Wang, B., Wang, Z.L., Wang, D.M., 2008. Multi-wire plaque crushing as a novel technique in treating chronic total occlusions. Chin. Med. J., 121(6):518-521.

[11]Kinoshita, I., Katoh, O., Nariyama, J., Otsuji, S., Tateyama, H., Kobayashi, T., Shibata, N., Ishihara, T., Ohsawa, N., 1995. Coronary angioplasty of chronic total occlusions with bridging collateral vessels: immediate and follow-up outcome from a large single-center experience. J. Am. Coll. Cardiol., 26(2):409-415.

[12]Kirtane, A.J., Stone, G.W., 2007. The anchor-Tornus technique: a novel approach to “uncrossable” chronic total occlusions. Catheter. Cardiovasc. Interv., 70(4):554-557.

[13]Matsumi, J., Saito, S., 2008. Progress in the retrograde approach for chronic total coronary artery occlusion: a case with successful angioplasty using CART and reverse-anchoring techniques 3 years after failed PCI via a retrograde approach. Catheter. Cardiovasc. Interv., 71(6):810-814.

[14]Nakamura, M., Shiba, M., Wada, M., 2006. A novel method for deploying a stent into a highly angulated position through use of a stent strut: application of a five-in-seven system. J. Invasive Cardiol., 18(3):E105-E107.

[15]Nakamura, S., Bae, J.H., 2008. Recent progress of the use of interventional therapy for chronic total occlusion. Korean Circ. J., 38(6):295-300.

[16]Saito, S., 2008. Different strategies of retrograde approach in coronary angioplasty for chronic total occlusion. Catheter. Cardiovasc. Interv., 71(1):8-19.

[17]Stone, G.W., Kandzari, D.E., Mehran, R., Colombo, A., Schwartz, R.S., Bailey, S., Moussa, I., Teirstein, P.S., Dangas, G., Baim, D.S., et al., 2005a. Percutaneous recanalization of chronically occluded coronary arteries: a consensus document. Part I. Circulation, 112(15):2364-2372.

[18]Stone, G.W., Reifart, N.J., Moussa, I., Hoye, A., Cox, D.A., Colombo, A., Baim, D.S., Teirstein, P.S., Strauss, B.H., Selmon, M., et al., 2005b. Percutaneous recanalization of chronically occluded coronary arteries: a consensus document. Part II. Circulation, 112(16):2530-2537.

[19]Stone, G.W., Colombo, A., Teirstein, P.S., Moses, J.W., Leon, M.B., Reifart, N.J., Mintz, G.S., Hoye, A., Cox, D.A., Baim, D.S., 2005c. Percutaneous recanalization of chronically occluded coronary arteries: procedural techniques, devices, and results. Catheter. Cardiovasc. Interv., 66(2):217-236.

[20]Surmely, J.F., Cook, S., 2007. Variation on the Anchor balloon technique for difficult stent delivery. Kardiovaskuläre Medizin, 10:397-399.

[21]Takahashi, S., Saito, S., Tanaka, S., Miyashita, Y., Shiono, T., Arai, F., Domae, H., Satake, S., Itoh, T., 2004. New method to increase a backup support of a 6 French guiding coronary catheter. Catheter Cardiovasc. Interv., 63(4):452-456.