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Aims: To describe the contemporary approach of chronic total occlusion (CTO) treatment of patients at the Thoraxcenter, Rotterdam, The Netherlands. Additionally, to make a critical appraisal of the performance of state-of-the-art CTO dedicated guidewires and devices in a prospective registry of patients.

Methods And Results: During 20 months, a total of 160 consecutive patients (165 CTOs) were enrolled.

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The 0.014 inch magnum Meier wire was used as the primary tool for recanalization of chronic total coronary artery occlusions in 230 consecutive patients treated by a single operator over a 3-year period. Exclusive use of the magnum wire resulted in an acute success rate of 80.

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Chronic coronary occlusions are still a therapeutic challenge to the interventional cardiologist. New techniques such as laser wire have improved recanalization rates, but outcomes are still far from satisfactory. We report the results of a nonrandomized single-center investigation using a hydrophilic-coated guidewire (Terumo Crosswire).

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Crosswire for recanalization of total occlusive coronary arteries.

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November 1998

Department of Cardiology, Cardiothoracic Sciences Centre, All India Institute of Medical Sciences, New Delhi.

Coronary angioplasty of total occlusions is technically difficult and is associated with limited success rates. The procedural outcome is mainly determined by the underlying pathological process. Recanalization of total occlusions is aimed at finding the passage with least resistance, without causing dissection or perforation.

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