Abstract
Chronic coronary occlusions are a frequent finding in coronary angiography. Existing
collaterals can rarely maintain sufficient perfusion during exercise, so that patients
with viable myocardium suffer typical angina due to ischemia.
Aim of a recanalization of a chronic target occlusion is to reduce the symptoms and
ischemia and to improve left ventricular function. Successful recanalisation may improve
the long-term outcome of the patient. A cardiac MRI can determine myocardial viability
and should be performed prior to percutaneous coronary intervention of a chronic target
occlusion. The recanalization of chronic occluded vessels requires special techniques,
including an antegrade and or retrograde approach. A careful procedure planning combined
with a thoughtful selection of the guiding catheter, microcatheter and exchange guidewires
will increase the chances for success. For the long-term result modern drug-eluting
stents should be used exclusively.
