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July 9, 2026Journal of the American College of Cardiology

Current Perspectives on Coronary Chronic Total Occlusions

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Key result

CTOs affect ~18% of patients undergoing nonemergent angiography for significant CAD but rarely prompt PCI.

  • n=1,697

Authors

PFPaul FeferMKMerril L. KnudtsonACAsim N. Cheema

Discussion

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Overview

Novel endovascular approaches may improve CTO success and QoL; leaves open whether they should change practice pending randomized confirmation.

Key Points

  • To explore contemporary approaches for managing chronic total occlusions in coronary arteries.
  • Review of current literature on chronic total occlusions and recent interventions
  • Analysis of various treatment strategies and outcomes
  • Evaluation of patient populations and clinical implications
  • Novel endovascular approaches show promise in increasing successful revascularization rates.
  • Outcomes indicate improved quality of life post-intervention.
  • Biomarkers are identified as useful in predicting treatment responses.

Study Design

Type

Observational (n=1,697)

Multicenter

Yes

PICO

P
Population
1,697 consecutive patients with coronary chronic total occlusions undergoing nonurgent coronary angiography at 3 Canadian sites, excluding those with prior CABG or acute STEMI.
E
Exposure / Comparator
Coronary chronic total occlusions
O
Primary Outcome
Prevalence, clinical characteristics, and management of coronary chronic total occlusions

Cite This Study

Fefer et al. (2012) conducted an observational in Coronary chronic total occlusions (n=1,697). Coronary chronic total occlusions was evaluated on Prevalence, clinical characteristics, and management of coronary chronic total occlusions. Chronic total occlusions were present in 18.4% of patients undergoing nonemergent angiography with significant coronary artery disease, and only 10% underwent attempted percutaneous intervention.

synapsesocial.com/papers/6a4fbbf0cdce3c5ce847d759https://doi.org/10.1016/j.jacc.2011.12.007
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