Current evidence for prognostic benefit of intravascular imaging-guided percutaneous coronary intervention in chronic total occlusion intervention

Although percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) has been increasing in recent years, CTO PCI is still one of the most challenging procedures with relatively higher rates of procedural complications and adverse clinical events after PCI. Due to the innate limitatio...

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Published in:The Korean journal of internal medicine 2024, 39(5), , pp.702-716
Main Authors: Hong, David, Kim, Sung Eun, Lee, Seung Hun, Lee, Seung-Jae, Lee, Jong-Young, Kim, Sang Min, Lee, Sang Yeub, Kwon, Woochan, Choi, Ki Hong, Park, Taek Kyu, Yang, Jeong Hoon, Song, Young Bin, Choi, Seung-Hyuk, Gwon, Hyeon-Cheol, Hahn, Joo-Yong, Lee, Joo Myung
Format: Article
Language:English
Subjects:
Chronic Disease
chronic total occlusion
Coronary Angiography
coronary artery disease
Coronary Occlusion - diagnostic imaging
Coronary Occlusion - therapy
Humans
intravascular imaging
percutaneous coronary intervention
Percutaneous Coronary Intervention - adverse effects
Predictive Value of Tests
procedural optimization
Review
Risk Factors
Treatment Outcome
Ultrasonography, Interventional
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Summary:Although percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) has been increasing in recent years, CTO PCI is still one of the most challenging procedures with relatively higher rates of procedural complications and adverse clinical events after PCI. Due to the innate limitations of invasive coronary angiography, intravascular imaging (IVI) has been used as an adjunctive tool to complement PCI, especially in complex coronary artery disease. Considering the complexity of CTO lesions, the role of IVI is particularly important in CTO intervention. IVI has been a useful adjunctive tool in every step of CTO PCI including assisted wire crossing, confirmation of wire location within CTO segment, and stent optimization. The meticulous use of IVI has been one of the greatest contributors to recent progress of CTO PCI. Nevertheless, studies evaluating the role of IVI during CTO PCI are limited. The current review provides a comprehensive overview of the mechanistic advantages of IVI in CTO PCI, summarizes previous studies and trials, and presents future perspective of IVI in CTO PCI.
ISSN:1226-3303
2005-6648
2005-6648
DOI:10.3904/kjim.2023.420