Contemporary Techniques for Coronary Chronic Total Occlusions Revascularisation: Sharing Experience in a Global World: Proceedings of a satellite symposium held at EuroPCR on May 20th - 23rd 2014 in Paris Katrina Mountfort, Medical Writer, Radcliffe Cardiology.

Chronic total occlusions (CTO) are the most challenging lesions treated by interventional cardiologists. A symposium at EuroPCR 2014 discussed factors influencing the success of percutaneous intervention (PCI) in CTO. Current treatment paradigms suggest that one or two vessel disease should be treated by PCI while three-vessel disease requires surgery if complete revascularisation cannot be achieved with PCI. In patients with CTO and multi-vessel disease timing is key, and evidence of ischaemic burden and expected completeness of revascularisation is required before PCI is undertaken. Other factors affecting procedural success include the available equipment and expertise of the operator. Flexiblity in strategy selection is also important as it is frequently necessary to switch strategies during the procedure. The presentation included two live cases that illustrated the complexity of this procedure.