Microvessels in chronic total occlusions: Pathways for successful guidewire crossing?

Bradley H. Strauss, Amit Segev, Graham A. Wright, Beiping Qiang, Nigel Munce, Kevan J.T. Anderson, General Leung, Alexander J. Dick, Renu Virmani, Jagdish Butany

Research output: Contribution to journalArticlepeer-review


Arterial chronic total occlusions (CTO) are a common and clinically relevant problem in patients with coronary artery disease. Percutaneous coronary intervention (PCI) success rates in a wide range of CTO are low, primarily due to inability of guidewire crossing. The pathophysiology of CTO is poorly understood and limits our ability to introduce innovative therapies. Recent studies from our laboratory have suggested that microvessel formation within arterial CTO is a complex process with temporal and regional differences. Moreover, there is evidence from pilot studies that the presence of either microvessels or the particular extracellular matrix environment in the adjacent perivascular tissue can facilitate guidewire crossing and successful PCL Currently, studies are underway in our experimental CTO model to delineate the pathophysiology of microvessel formation in CTO and its potential role in PCI.

Original languageEnglish
Pages (from-to)425-436
Number of pages12
JournalJournal of Interventional Cardiology
Issue number6
StatePublished - Dec 2005
Externally publishedYes


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