ABSTRACT
Prior to starting the intervention, the diagnostic films must be carefully studied to determine the appropriate course of action that will ensure the greatest chances of success. Once the decision has been made to proceed, there may come a point when one must make a decision to stop and try a different technique, stop and retry another day, or stop completely. Factors that play into this decision-making process include futility, complications, and partial success. In addition to reviewing the different clinical scenarios, wires, and devices to ensure success in percutaneous revascularization of a chronic total occlusion (CTO), it is just as important to understand the limitations of these techniques in deciding when to stop the procedure to prevent potential complications. Serious complications related to percutaneous coronary intervention in CTO include vessel dissection and perforation. Prevention of both is key to procedure success; however, early recognition can also lead to success and prevent further major complications.
