TY - JOUR
T1 - The role of intravascular imaging in chronic total occlusion percutaneous coronary intervention
AU - Xenogiannis, Iosif
AU - Pavlidis, Antonis N.
AU - Kaier, Thomas E.
AU - Rigopoulos, Angelos G.
AU - Karamasis, Grigoris V.
AU - Triantafyllis, Andreas S.
AU - Vardas, Panos
AU - Brilakis, Emmanouil S.
AU - Kalogeropoulos, Andreas S.
N1 - Publisher Copyright:
2023 Xenogiannis, Pavlidis, Kaier, Rigopoulos, Karamasis, Triantafyllis, Vardas, Brilakis and Kalogeropoulos.
PY - 2023
Y1 - 2023
N2 - Chronic total occlusions (CTOs) represent the most complex subset of coronary artery disease and therefore careful planning of CTO percutaneous coronary recanalization (PCI) strategy is of paramount importance aiming to achieve procedural success, and improve patient's safety and post CTO PCI outcomes. Intravascular imaging has an essential role in facilitating CTO PCΙ. First, intravascular ultrasound (IVUS), due to its higher penetration depth compared to optical coherence tomography (OCT), and the additional capacity of real-time imaging without need for contrast injection is considered the preferred imaging modality for CTO PCI. Secondly, IVUS can be used to resolve proximal cap ambiguity, facilitate wire re-entry when dissection and re-entry strategies are applied and most importantly to guide stent deployment and optimization post implantation. The role of OCT during CTO PCI is currently limited to stent sizing and optimization, however, due to its high spatial resolution, OCT is ideal for detecting stent edge dissections and strut malapposition. In this review, we describe the use of intravascular imaging for lesion crossing, plaque characterization and wire tracking, extra- or intra-plaque, and stent sizing and optimization during CTO PCI and summarize the findings of the major studies in this field.
AB - Chronic total occlusions (CTOs) represent the most complex subset of coronary artery disease and therefore careful planning of CTO percutaneous coronary recanalization (PCI) strategy is of paramount importance aiming to achieve procedural success, and improve patient's safety and post CTO PCI outcomes. Intravascular imaging has an essential role in facilitating CTO PCΙ. First, intravascular ultrasound (IVUS), due to its higher penetration depth compared to optical coherence tomography (OCT), and the additional capacity of real-time imaging without need for contrast injection is considered the preferred imaging modality for CTO PCI. Secondly, IVUS can be used to resolve proximal cap ambiguity, facilitate wire re-entry when dissection and re-entry strategies are applied and most importantly to guide stent deployment and optimization post implantation. The role of OCT during CTO PCI is currently limited to stent sizing and optimization, however, due to its high spatial resolution, OCT is ideal for detecting stent edge dissections and strut malapposition. In this review, we describe the use of intravascular imaging for lesion crossing, plaque characterization and wire tracking, extra- or intra-plaque, and stent sizing and optimization during CTO PCI and summarize the findings of the major studies in this field.
KW - chronic total occlusion (CTO)
KW - CTO crossing
KW - intravascular imaging
KW - intravascular ultrasound (IVUS)
KW - optical coherence tomography (OCT)
KW - stent optimization
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U2 - 10.3389/fcvm.2023.1199067
DO - 10.3389/fcvm.2023.1199067
M3 - Review article
C2 - 37767372
AN - SCOPUS:85172024986
SN - 2297-055X
VL - 10
JO - Frontiers in Cardiovascular Medicine
JF - Frontiers in Cardiovascular Medicine
M1 - 1199067
ER -