Climbing PCI success rates in complex chronic total occlusions: joining “The Club”

Coronary chronic total occlusions (CTO) have been termed the “last frontier” of percutaneous coronary intervention (PCI)1, and remain one of the most technically challenging lesion subsets with lower rates of procedural success, higher complication rates, greater radiation exposure, and longer procedure times compared with interventions in non-CTO stenoses. For these reasons, CTO remains a common indication for referral for coronary artery bypass grafting (CABG)2. However grafting of the CTO can also be challenging, as shown in the SYNTAX (SYNergy Between PCI With TAXUS and Cardiac Surgery) clinical trial CTO subset, in which successful bypass grafting of the CTO was achieved ...