Percutaneous coronary intervention for chronic total occlusion

Prof Alfredo R Galassi, MD , FACC, FESC, FSCAI
Associate Professor of Cardiology
Head of the Catheterization Laboratory and Cardiovascular Interventional
Unit  Clinical Division of Cardiology, Ferrarotto Hospital
University of Catania

in collaboration  with
Salvatore D Tomasello, MD, Research Fellow, University of Catania
Luca Costanzo, MD, Postgraduate School, University of Catania
Giombattista Barrano, MD, Postgraduate School, University of Catania

Chapters

1. History of CTO revascularization and evolution of techniques
2. Anatomy and histopathology of CTO
3. Epidemiology and definition of CTO
4. Clinical indication to CTO recanalization and patient selection
5. Non invasive functional imaging tests to assess viable and ischemic myocardium
6. The role of collateral circulation and its assessment
7. The role of MSCT scan in complex lesions
8. Predictive factors related to success or failure of recanalization
9. Drug-eluting stents for CTO lesions
10. Basic principles and materials for CTO recanalization
11. Antegrade approach (a cases oriented approach):
    – wiring techniques (single, parallel, see-saw, side branch, etc)‏
    – guiding techniques (anchor balloon, mother in child, IVUS guided)‏
    – role of devices (crosser, tornus, venture, laser, ovalum, etc)
12. Retrograde approach: (retrograde wiring, kissing wires, knuckle technique, CART technique)‏
13. The PCI strategy after crossing the lesion by guidewire
14. When to stop procedure, when to perform a second attempt
15. Procedural complications
16. Radiation and contrast media exposure
17. Management of complication and general issues
18. Operator training and organization of CTO centers