An Overview of Chronic Total Occlusion Revascularization Using Retrograde Versus Antegrade Approach

Abstract

Coronary chronic total occlusion (CTO) and percutaneous coronary interventions (PCI) can be challenging with failure to cross being the main cause of failure.  Ongoing ischemia is associated with worse clinical outcomes and successful CTO-PCI is important for relieving ischemia and helping achieve complete coronary revascularization. Most of studies performed to date are unfortunately limited by their retrospective, observational designs and were not compared with a control group that was only receiving medical therapy. In addition, patients who have unsuccessful CTO-PCI are more likely to have complications at the time of their procedure, potentially biasing the results in favor of successful CTO-PCI. Deciding when to proceed with CTO-PCI depends on the balance of the anticipated risks and benefits of the procedure CTO-PCI successfully and safely. The aim of this article was to review the different methods for CTO revascularization.