Recent Progress of the Use of Interventional Therapy for Chronic Total Occlusion

Chronic total occlusion (CTO) remains one of the most challenging lesion subsets for interventional cardiologists due to a low success rate and higher incidence of restenosis, especially with current use of bare metal stents (BMSs). However, successful CTO revascularization has a beneficial effect on long-term survival and relief of angina. With recent advances in technology (with the use of special techniques and devices), the initial success rate of recanalization of occlusions is quite high (approximately 90%). However, the long-term clinical outcome of the use of bare metal stents is not satisfactory due to a high restenosis rate. Recently, the introduction of the sirolimus-eluting stent (SES) and paclitaxel-eluting stent (PES) has shown favorable clinical outcomes, such as a reduction in the restenosis rate in patients with CTOs. Consequently, the use of the new types of stents can reduce the incidence of major adverse cardiac events detected at follow-up.

Drug-Eluting Stent Strut Fracture as a Cause of Restenosis

We report a case of in-stent restenosis due to the fracture of a sirolimus-eluting stent, which was confirmed by intravascular ultrasound. It can be suggested that a stent fracture is an important cause of restenosis in this era of drug-eluting stents.