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JACC Cardiovasc Interv. 2016 Oct 10;9(19):1979-1991. doi: 10.1016/j.jcin.2016.06.057.

Utility of Intravascular Ultrasound in Percutaneous Revascularization of Chronic Total Occlusions: An Overview.

Author information

1
Department of Clinical and Experimental Medicine, University of Catania, Italy; University Heart Center, University Hospital Zurich Switzerland. Electronic address: argalassi@gmail.com.
2
Internal Division of Cardiology for Education and Research Osaka University, Osaka, Japan.
3
Department of Clinical and Experimental Medicine, University of Catania, Italy; Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
4
Veterans Administration North Texas Healthcare System and University of Texas Southwestern Medical School, Dallas, Texas.
5
NIHR Cardiovascular BRU Royal Brompton Hospital & National Heart and Lung Institute, Imperial College London, London, United Kingdom.
6
Policlinico San Giovanni Bosco, Turin, Italy.
7
Department of Cardiology, Forth Valley Royal Hospital, Larbert, United Kingdom.
8
Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark.
9
Department of Cardiology, Infermi Hospital, Rivoli, Italy.
10
Clinique Générale de Marignane, Marseille, France.
11
Department of Cardiology, American Hellenic Educational Progressive Association University Hospital, Thessaloniki, Greece.
12
Medizinische Klinik I (Cardiology & Intensive Care), Klinikum Darmstadt GmbH, Darmstadt, Germany.

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.

KEYWORDS:

PCI; chronic total occlusions; intracoronary imaging; intravascular ultrasound

PMID:
27712732
DOI:
10.1016/j.jcin.2016.06.057
[Indexed for MEDLINE]
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