For all of the recent advances that have taken place in interventional cardiology, one of the most vexing remaining problems is the difficulty presented by chronic total occlusions (CTOs), which are arterial vessel blockages that preclude blood flow distal of the blockage. A recently completed international multi-center five-year study reported one or more CTOs in 31% of all angiographic procedures studied. This translates to one million coronary procedures and 900,000 peripheral vascular procedures performed worldwide in 1999 in which a patient will be found to have at least one chronic total occlusion.
The problem CTOs pose for interventional cardiologists lies in safely crossing and carving out a channel, or recanalizing, through the occlusion. For a CTO to be recanalized, the physicians must...
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