Percutaneous revascularization of coronary chronic total occlusion.

Percutaneous coronary intervention for chronic total occlusions is the most challenging and time consuming intervention in Cardiology. It is evolving rapidly, well documented by a success rate that in the hands of specifically trained operators recently increased from about 60% to 90% and longterm patency because of drug eluting stents from 50% to 90%. These results are comparable or even superior to surgical revascularisation. Sophisticated techniques unique to CTO interventions were developed and the need for specific training is emphasised so that the success rate of at least 80% as claimed by the ESC guidelines on myocardial revascularization can be met and patients with CTO who deserve revascularization no longer be denied appropriate treatment.