Algorithmic solutions to common problems encountered during chronic total occlusion angioplasty: The algorithms within the algorithm

Robert F. Riley, Simon J. Walsh, Ajay J. Kirtane, R. Michael Wyman, William J. Nicholson, Lorenzo Azzalini, James C. Spratt, Sanjog Kalra, Colm G. Hanratty, Ashish Pershad, Tony DeMartini, Dimitri Karmpaliotis, William L. Lombardi, J. Aaron Grantham

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

Improved technical equipment, dissemination of best practices, and the importance of complete coronary revascularization have led to a renewed interest in coronary chronic total occlusion (CTO) PCI. In particular, the hybrid algorithm has been associated with increasing procedural success rates in the US. However, the hybrid algorithm only covers overarching strategies in the overall approach to these lesions. Several technical challenges can occur during execution of these approaches, each of which has several potential solutions. A systematic or algorithmic approach to dealing with these challenges could contribute to improved procedural efficiency and higher procedural success. While there have been isolated attempts in the past to codify approaches to each of these situations, there has not been a contemporary, comprehensive review of the potential solutions to these problems. We present 10 common problems encountered during CTO PCI and a consensus hierarchical approach to them.

Original languageEnglish
Pages (from-to)286-297
Number of pages12
JournalCatheterization and Cardiovascular Interventions
Volume93
Issue number2
DOIs
StatePublished - 1 Feb 2019
Externally publishedYes

Keywords

  • consensus
  • percutaneous coronary intervention
  • solutions

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