The Role of Coronary CT Angiography in Chronic Total Occlusion Coronary Intervention

Abstract

Context: The application of coronary computed tomography angiography (CCTA) is increasingly being recognized for its role in diagnosing and ruling out coronary artery disease (CAD). This editorial letter discusses the usefulness of CCTA in planning for chronic total occlusion percutaneous coronary intervention (CTO PCI). Evidence Acquisition: We searched for articles using Google Scholar and the PubMed Database. The keywords used were "Coronary CT Angiography (CCTA)," "Chronic Total Occlusion (CTO) intervention," "pre-procedural CTO PCI," and "post-CTO interventions." The articles included in the review were published between 2013 and 2023. Results: Regarding pre-procedural planning for the revascularization of chronic total occlusions (CTOs), there is significant interest in the ability of CCTA to visualize and analyze coronary atherosclerotic plaque. Additionally, CCTA can provide three-dimensional coronary vessel imaging. Following post-CTO intervention, CCTA is utilized to determine whether the formation of new channels and plaque remodeling will improve the chances of future successful interventions. Conclusions: CCTA allows for the precise assessment of anatomical features without invasive procedures, making the diagnosis of CAD easier. The technology is advancing rapidly, with new scanners offering higher resolution, better-quality images, and reduced radiation exposure.