Utility of Intravascular Ultrasound in Percutaneous Revascularization of Chronic Total Occlusions

• Published in: JACC. Cardiovascular interventions Vol. 9; no. 19; pp. 1979 - 1991
• Main Authors: Galassi, Alfredo R., MD, Sumitsuji, Satoru, MD, Boukhris, Marouane, MD, Brilakis, Emmanouil S., MD, PhD, Di Mario, Carlo, MD, Garbo, Roberto, MD, Spratt, James C., MD, Christiansen, Evald H., MD, PhD, Gagnor, Andrea, MD, Avran, Alexandre, MD, Sianos, Georgios, MD, PhD, Werner, Gerald S., MD
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 10.10.2016
• Subjects: Cardiovascular; chronic total occlusions; intracoronary imaging; intravascular ultrasound; PCI; intravascular ultrasound; drug-eluting stents; IVUS; intracoronary imaging; major adverse cardiac event(s); controlled antegrade retrograde tracking; chronic total occlusions; percutaneous coronary intervention; DES; MACE; PCI; chronic total occlusion; CART; CTO
• ISSN: 1936-8798; 1876-7605
• DOI: 10.1016/j.jcin.2016.06.057

Abstract Intravascular ultrasound has been used for >20 years to guide percutaneous coronary intervention in different subsets of coronary lesions. During the last decade, the interest in percutaneous coronary intervention for chronic total occlusion (CTO) has increased dramatically, leading to high success rates. Failure of guidewire crossing is the most common reason for failed CTO attempts. Certain angiographic features, such as blunt proximal CTO cap, tortuosity, heavy calcification, and lack of visibility of path in the distal vessel, increase procedural difficulty. A better understanding of the behavior of the guidewire within the CTO segment may represent a key issue to achieve successful outcome. In this respect, intravascular ultrasound imaging might have potential roles in the recanalization of CTOs. In this paper, we focused on the usefulness and the applications of intravascular ultrasound imaging in percutaneous CTO recanalization, underlying its impact on clinical outcome.