L'angioplastica coronarica nelle occlusioni coronariche croniche dell'anziano

Chronic Total Occlusion (CTO) lesions represent a great challenge for interventional cardiologist, especially for the strong relationship between procedural success and positive clinical outcome. However, the particular features of these lesions may determine technical problems that limit the chances of revascularization success, especially in older patients. Furthermore, in the elderly, is very important the choice between conservative and invasive strategy, especially in the context of stable ischemic symptoms, which is the most frequent clinical condition in the CTO subset. In this review we emphasize the potential limitations of CTO PCI related to advanced age of the patients, considering valid alternative strategies aimed to overcome such problems. We emphasized that age may not be the only element to consider when choosing whether to proceed to PCI. It's essential, therefore, a careful selection of the patient and an accurate risk stratification, providing a strategy as much as possible customized, with the aim to minimize limitations and complications of PCI.