Systematic Review of Coronary Computed Tomography Angiography Guidance for Chronic Total Occlusion Percutaneous Coronary Intervention
Recommended Citation
Kumar S, Carvalho PEP, Strepkos D, Alexandrou M, Opolski MP, Azzalini L, Alaswad K, Basir MB, Jaffer F, Collet C, Leipsic J, Cavalcante J, Rangan BV, Sandoval Y, Brilakis ES. Systematic Review of Coronary Computed Tomography Angiography Guidance for Chronic Total Occlusion Percutaneous Coronary Intervention. Am J Cardiol. 2026;271:164-175.
Document Type
Article
Publication Date
7-15-2026
Publication Title
The American journal of cardiology
Keywords
Humans, Coronary Occlusion, Percutaneous Coronary Intervention, Coronary Angiography, Chronic Disease, Computed Tomography Angiography
Abstract
Coronary computed tomography angiography (CCTA) is emerging as a valuable adjunct for chronic total occlusion (CTO) percutaneous coronary intervention (PCI), particularly for lesions in which angiography incompletely defines procedural anatomy. In this systematic review, the authors evaluated the role of CCTA in CTO diagnosis, lesion characterization, prediction of guidewire crossing and procedural success, and procedural guidance. CCTA provides a detailed assessment of key features that directly influence CTO PCI strategy and outcomes. Randomized and observational data suggest that preprocedural CCTA can improve procedural planning, increase technical success in complex lesions, and support safer and more efficient CTO PCI through fluoroscopic co-registration and other real-time guidance applications. These findings highlight the clinical value of CCTA as a tool that can enhance case selection, optimize crossing strategy, and improve procedural success in contemporary CTO PCI.
Medical Subject Headings
Humans; Coronary Occlusion; Percutaneous Coronary Intervention; Coronary Angiography; Chronic Disease; Computed Tomography Angiography
PubMed ID
42069285
Volume
271
First Page
164
Last Page
175
