Pavlidis Antonis N, Jones Daniel A, Sirker Alex, Mathur Anthony, Smith Elliot J
Department of Cardiology, London Chest Hospital, Barts Health NHS Trust, London, United Kingdom.
Department of Cardiology, London Chest Hospital, Barts Health NHS Trust, London, United Kingdom.
Am J Cardiol. 2015 Mar 15;115(6):844-51. doi: 10.1016/j.amjcard.2014.12.047. Epub 2015 Jan 6.
Chronic total occlusions (CTOs) represent a major challenge in percutaneous coronary revascularization. The recent advances in strategies and techniques and the development of dedicated equipment, such as microcatheters and wires, have resulted in considerably higher success rates. Although successful CTO recanalization is associated with significant clinical benefits, including improvement of angina, quality of life, reduced need for surgical revascularization, and improvement of left ventricular function, CTO procedures may require prolonged x-ray exposure and use of larger volumes of contrast compared with non-CTO procedures. Large volumes of contrast medium have been associated with increased rates of contrast-induced acute kidney injury (CI-AKI) and adverse short- and long-term outcomes. Application of specific measures and algorithms should be considered by all CTO operators to prevent CI-AKI.
