Intravascular Imaging for Chronic Total Occlusion Intervention

Iosif Xenogiannis, Peter Tajti, Dimitri Karmpaliotis, Roberto Garbo, Andrea Gagnor, M. Nicholas Burke, Emmanouil S Brilakis

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations


Purpose of Review: We sought to summarize the current evidence on use of intravascular imaging (with intravascular ultrasound [IVUS] or optical coherence tomography [OCT]) in chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Recent Findings: Utilization of intravascular imaging in CTO PCI is increasing over time, both to facilitate CTO crossing and for optimization of the final result. OCT is used less often than IVUS due to its lower depth of penetration and need for contrast injection. Summary: Intravascular imaging has multiple uses in CTO PCI: (a) it can facilitate CTO crossing by resolving proximal cap ambiguity and facilitating and confirming true lumen wire re-entry in case of initial subintimal wire crossing in both the antegrade and retrograde direction (for example by selecting the appropriate balloon size during the reverse controlled antegrade and retrograde tracking (reverse CART) technique; (b) it can be used to optimize the PCI result by ensuring good stent expansion and stent strut apposition, which may in turn result in lower rates of subsequent in-stent restenosis and stent thrombosis; (c) can facilitate evaluation and treatment of complications.

Original languageEnglish (US)
Article number31
JournalCurrent Cardiovascular Imaging Reports
Issue number12
StatePublished - Dec 1 2018


  • CTO
  • Chronic total occlusions
  • Coronary artery disease
  • IVUS
  • Intravascular imaging
  • Percutaneous coronary interventions

ASJC Scopus subject areas

  • Histology
  • Applied Microbiology and Biotechnology
  • Cell Biology


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