Use of Intravascular Imaging During Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Contemporary Multicenter Registry
Karacsonyi J, Alaswad K, Jaffer FA, Yeh RW, Patel M, Bahadorani J, Karatasakis A, Danek BA, Doing A, Grantham JA, Karmpaliotis D, Moses JW, Kirtane A, Parikh M, Ali Z, Lombardi WL, Kandzari DE, Lembo N, Garcia S, Wyman MR, Alame A, Nguyen-Trong PK, Resendes E, Kalsaria P, Rangan BV, Ungi I, Thompson CA, Banerjee S, Brilakis ES. Use of intravascular imaging during chronic total occlusion percutaneous coronary intervention: Insights from a contemporary multicenter registry. J Am Heart Assoc. 2016;5(8)
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: http://www.clinicaltrials.gov. Unique identifier: NCT02061436.
Medical Subject Headings
Aged; Chronic Disease; Coronary Angiography; Coronary Occlusion; Female; Humans; Male; Multimodal Imaging; Percutaneous Coronary Intervention; Registries; Tomography, Optical Coherence; Ultrasonography, Interventional