Current challenges and prevention strategies for chronic total occlusion (CTO) complications

Judit Karacsonyi, Evangelia Vemmou, Ilias Nikolakopoulos, Imre Ungi, Nidal Abi Rafeh, Ahmed ElGuindy, Lorenzo Azzalini, M. Nicholas Burke, Emmanouil S. Brilakis

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Introduction: Percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) can be challenging, but high success rates (85–90%) are currently achieved at experienced centers with approximately 3% risk for a major periprocedural complication. Areas covered: CTO PCI complications can be categorized according to location such as cardiac and non-cardiac (vascular access complications, thromboembolic complications, contrast-related and radiation injury) complications. Cardiac complications are further subdivided into coronary (acute closure, perforation, and equipment loss or entrapment) and non-coronary (hypotension, myocardial infarction, tamponade, arrhythmias). Expert opinion: In this article, we review strategies to prevent and treat CTO PCI complications. Careful monitoring throughout the case enables prevention and early detection of a complication. If a complication occurs, rapid implementation of treatment using an algorithmic approach can minimize its adverse impact.

Original languageEnglish
Pages (from-to)337-347
Number of pages11
JournalExpert Review of Cardiovascular Therapy
Issue number4
StatePublished - 2021
Externally publishedYes


  • Complication
  • chronic total occlusion
  • management
  • percutaneous coronary intervention


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