Use of Intravascular Imaging During Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Contemporary Multicenter Registry

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J Am Heart Assoc


BACKGROUND: Intravascular imaging can facilitate chronic total occlusion (CTO) percutaneous coronary intervention.

METHODS AND RESULTS: We examined the frequency of use and outcomes of intravascular imaging among 619 CTO percutaneous coronary interventions performed between 2012 and 2015 at 7 US centers. Mean age was 65.4±10 years and 85% of the patients were men. Intravascular imaging was used in 38%: intravascular ultrasound in 36%, optical coherence tomography in 3%, and both in 1.45%. Intravascular imaging was used for stent sizing (26.3%), stent optimization (38.0%), and CTO crossing (35.7%, antegrade in 27.9%, and retrograde in 7.8%). Intravascular imaging to facilitate crossing was used more frequently in lesions with proximal cap ambiguity (49% versus 26%, P

CONCLUSIONS: Intravascular imaging is frequently performed during CTO percutaneous coronary intervention both for crossing and for stent selection/optimization. Despite its use in more complex lesion subsets, intravascular imaging was associated with similar rates of technical and procedural success for CTO percutaneous coronary intervention.

CLINICAL TRIAL REGISTRATION: URL: Unique identifier: NCT02061436.


© authors, original version available at: 10.1161/JAHA.116.003890

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Medical Subject Headings

Aged; Chronic Disease; Coronary Angiography; Coronary Occlusion; Female; Humans; Male; Multimodal Imaging; Percutaneous Coronary Intervention; Registries; Tomography, Optical Coherence; Ultrasonography, Interventional

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