JIM Today 2018 - Thursday - page 3

Issue 1 
Thursday
 22 February 2018 
JIM today
3
regards to broad dissemination
of complex CTO skills, when
real-world concerns and limita-
tions are taken into account, Dr
Gasparini replied: “Nowadays,
indications to CTO recanalisation
should be reconsidered in light
of new evidence of current rates
of procedural success and clinical
effectiveness. The ‘therapeutic
nihilism’ often associated with their
treatment may be fueled by persis-
tent misconceptions of the actual
degree of ischaemia or symptoms
caused by the CTO, and the poten-
tial benefit of revascularisation.
“It is my opinion that an important
role was also played by the inability
to treat this subset of lesions by
many operators. This, however,
cannot and should not be one
of the criteria used to define a
patient as ‘non-revascularisable’.
In fact, referral to dedicated CTO
operators should be considered
before a patient is deemed unsuit-
able for any further percutaneous
revascularisation. I’m optimistic
that the growing attention to CTO
lesions can raise awareness about the
feasibility, efficacy and safety of these
procedures, assisting clinicians to
more judiciously determine indications
for CTO revascularisation.
“CTO PCI trains interventional-
ists to treat patients with complex
coronary anatomy safely and effec-
tively. As a result, CTO PCI becomes a
powerful motivator for learning and
applying new and often challeng-
ing techniques.”
Reference
1. Walsh SJ, Hanratty CG. Percutaneous coronary
intervention for chronic total occlusions: time
to move from the annex to mainstream?
EuroIntervention. 2016 Jan 22; 11(9):974-6.
LIVE CASES
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Thursday
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Saturday
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Columbus Hospital
“Nowadays, indications
to CTO recanalisation
should be reconsidered
in light of new evidence.”
Gabriele Gasparini
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