Uploaded August 2026 | Updated September 2026, 3 weeks ago
Guest: Abhiram Prasad, M.D.
Host: Paul Friedman, M.D.
Chronic total occlusions are frequently encountered and are associated with complex coronary artery disease and diffuse atherosclerosis. Percutaneous coronary intervention is a suitable option for relieving angina in select patients who remain symptomatic despite optimal medical therapy. Success rates of over 80% can be routinely achieved by CTO operators with MACE rates of less than 5%.
Topics Discussed:
• Who is the ideal patient for CTO PCI?
• Which practices in CTO PCI maximize success and minimize risk?
• Is there a role of viability testing when evaluating patients for CTO PCI?
• Is there a role for non-culprit CTO PCI for complete revascularization post AMI?
• Is there any new clinical trial data for CTO PCI?
• Are there any new devices for CTO PCI?
0:00 Understanding Chronic Total Occlusions
1:40 Symptoms and Ideal CTO-PCI Candidates
3:07 How CTO-PCI Procedures Are Performed
5:28 Success Rates and Potential Complications
7:07 When Viability Testing Is Helpful
8:17 Treating CTOs After a Heart Attack
9:58 Evaluating Ischemia and Symptom Burden
10:39 Clinical Trial Evidence for CTO-PCI
12:25 Emerging Tools for Calcified Occlusions
14:03 Closing Remarks and Education Resources
Guest: Abhiram Prasad, M.D.
Host: Paul Friedman, M.D.
Chronic total occlusions are frequently encountered and are associated with complex coronary artery disease and diffuse atherosclerosis. Percutaneous coronary intervention is a suitable option for relieving angina in select patients who remain symptomatic despite optimal medical therapy. Success rates of over 80% can be routinely achieved by CTO operators with MACE rates of less than 5%.
Topics Discussed:
• Who is the ideal patient for CTO PCI?
• Which practices in CTO PCI maximize success and minimize risk?
• Is there a role of viability testing when evaluating patients for CTO PCI?
• Is there a role for non-culprit CTO PCI for complete revascularization post AMI?
• Is there any new clinical trial data for CTO PCI?
• Are there any new devices for CTO PCI?
0:00 Understanding Chronic Total Occlusions
1:40 Symptoms and Ideal CTO-PCI Candidates
3:07 How CTO-PCI Procedures Are Performed
5:28 Success Rates and Potential Complications
7:07 When Viability Testing Is Helpful
8:17 Treating CTOs After a Heart Attack
9:58 Evaluating Ischemia and Symptom Burden
10:39 Clinical Trial Evidence for CTO-PCI
12:25 Emerging Tools for Calcified Occlusions
14:03 Closing Remarks and Education Resources
