ABSTRACT
INTRODUCTION Chronic total coronary occlusions (CTO) represent approximately 10% of lesions treated by percutaneous coronary intervention (PCI).1 CTOs are a common finding on diagnostic angiography; in one large registry, 52% of patients with significant coronary disease (defined as a coronary artery lesion with a diameter stenosis of >75%) had at least one CTO.2 Importantly, the presence of a CTO affects the subsequent choice of therapy made by the physician, with the majority of such patients managed medically or referred for coronary bypass graft surgery.2
This is likely to reflect the complex nature of these lesions and the perceived difficulty in treating them with PCI because of lower rates of success due to the inability to recanalize the lesion. However, the advancement of equipment particularly in wire technology, together with the adoption of specialized wiring techniques have improved PCI recanalization success rates in contemporary practice in many centers. Optimal angiographic images are vital in the assessment of CTO lesions to gain information of characteristics that deem the lesion suitable for a strategy of PCI.
