The Role of Coronary Computed Tomography Angiography in Chronic Total Occlusion Percutaneous Coronary Intervention.
Authors
Affiliations (10)
Affiliations (10)
- Department of Cardiology, Creighton University School of Medicine, Phoenix, Arizona, USA.
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland.
- Division of Cardiology, University of Ulsan College of Medicine, Heart Institute, Asan Medical Center, Seoul, Korea.
- Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium.
- Allina Health Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
- University Heart Center, Goethe University, Frankfurt am Main, Germany.
- Department of Medicine and Radiology, University of British Columbia, Vancouver, British Columbia, Canada.
- Division of Cardiology, Severance Cardiovascular Hospital, College of Medicine, Yonsei University, Seoul, Korea.
- Allina Health Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA. Electronic address: [email protected].
Abstract
Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) can be technically complex. Coronary computed tomography angiography (CTA) is increasingly being used for planning CTO PCI. Coronary CTA can help evaluate cap morphology, lesion length, calcification, and distal vessel quality. The use of coronary CTA for CTO PCI may be enhanced by integration with artificial intelligence and real-time imaging. In a randomized controlled trial, preprocedural coronary CTA increased the success of CTO PCI. In this review, the authors describe how coronary CTA can help diagnose and characterize CTO lesions, estimate the time needed for guidewire crossing time, predict and facilitate CTO PCI technical success, and provide real-time procedural guidance.