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Intravascular Imaging for Chronic Total Occlusion Intervention

  • Iosif Xenogiannis
  • Peter Tajti
  • Dimitri Karmpaliotis
  • Roberto Garbo
  • Andrea Gagnor
  • M. Nicholas Burke
  • Emmanouil S. Brilakis
Intravascular Imaging (MC Alraies, Section Editor)
  • 23 Downloads
Part of the following topical collections:
  1. Topical Collection on Intravascular Imaging

Abstract

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.

Keywords

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

Notes

Compliance with Ethical Standards

Conflict of Interest

Dr. Karmpaliotis reports speaker honoraria from Abbott Vascular, Boston Scientific, Medtronic, and Vascular Solutions.

Dr. Garbo is a consultant for Philips Volcano Europe.

Dr. Burke is a consultant for Abbott Vascular and Boston Scientific.

Dr. Brilakis reports consulting/speaker honoraria from Abbott Vascular, American Heart Association (associate editor Circulation), Amgen, Boston Scientific, Cardiovascular Innovations Foundation (Board of Directors), CSI, Elsevier, GE Healthcare, and Medtronic; research support from Siemens, Regeneron, and Osprey. Shareholder: MHI Ventures. Board of Trustees: Society of Cardiovascular Angiography and Interventions.

All other authors declare no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Iosif Xenogiannis
    • 1
  • Peter Tajti
    • 1
    • 2
  • Dimitri Karmpaliotis
    • 3
  • Roberto Garbo
    • 4
  • Andrea Gagnor
    • 5
  • M. Nicholas Burke
    • 1
  • Emmanouil S. Brilakis
    • 1
  1. 1.Abbott Northwestern HospitalMinneapolis Heart InstituteMinneapolisUSA
  2. 2.Division of Invasive Cardiology, Second Department of Internal Medicine and Cardiology CenterUniversity of SzegedSzegedHungary
  3. 3.Department of Invasive CardiologyColumbia UniversityNew YorkUSA
  4. 4.Department of Invasive CardiologySan Giovanni Bosco HospitalTurinItaly
  5. 5.Department of Invasive CardiologyMaria Vittoria HospitalTurinItaly

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