Visualization of collateral channels with coronary computed tomography angiography for the retrograde approach in percutaneous coronary intervention for chronic total occlusion

Sugaya, Teppei; Oyama‐Manabe, Noriko; Yamaguchi, Takayoshi; Tamaki, Nagara; Ishimaru, Shin’ichi; Okabayashi, Hiroaki; Furuya, Jungo; Yoshida, Toshihito; Igarashi, Yasumi; Igarashi, Keiichi

doi:10.1016/j.jcct.2016.01.003

Cited by 7 publications

(2 citation statements)

References 30 publications

(26 reference statements)

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“…It is challenging for CCTA to provide detailed information regarding collateral channels in retrograde PCI due to its limited spatial resolution [ 59 ]. In the study of Sugaya et al [ 60 ], the accuracy of CCTA for detecting collaterals used for the retrograde PCI was 74.5%, and a higher success rate with fewer complications was found in CCTA-visible collaterals than in those not apparent in CCTA. Nowadays, photon-counting CT with a spatial resolution of around 0.25 mm [ 61 ] may be potentially precise to assess collateral channels.…”

Section: Resultsmentioning

confidence: 99%

Coronary chronic total occlusion on coronary CT angiography: what radiologists should know?

Xu,

Ma,

Chen

et al. 2024

Insights Imaging

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Coronary chronic total occlusion (CTO) often occurs in patients with obstructive coronary artery disease, which remains one of the greatest challenges for interventional cardiologists. Coronary computed tomography angiography (CCTA) with its emerging post-processing techniques can provide a detailed assessment of CTO lesions before percutaneous coronary intervention (PCI), playing an important role in the clinical management of CTO PCI, from early diagnosis, pre-procedural outcome prediction, the crossing algorithm planning, intraprocedural guidance, and finally post-procedural assessment and follow-up. In addition, the feasibility of CT perfusion (CTP) in patients with CTO has been validated. Combined CCTA and CTP have the great potential to be the one-stop-shop imaging modality for assessing both anatomy and function of CTO lesions. This review aims to make radiologists understand the role of CCTA in the diagnosis and assessment of CTO lesions, thus assisting interventionalists in optimizing CTO PCI crossing strategies with the expertise of radiologists.Critical relevance statement The anatomical features of CTO on CCTA can reveal the complexity of CTO lesions and are associated with CTO PCI outcome, thus helping interventionalists optimize CTO PCI crossing strategies.Key points • CTO is the common lesion in invasive coronary angiography, and CTO PCI is technically difficult and its success rate is relatively low.• Length, collaterals, and attenuation-related signs can help distinguish CTO from subtotal occlusion.• The anatomical features of CTO lesions can help grade the difficulty of CTO PCI and predict procedural outcomes and long-term outcomes of CTO PCI.• The real-time fusion of CCTA with fluoroscopic angiography can be applied in highly complicated CTO lesions.• After CTO PCI, CCTA can help guide a second CTO PCI re-entry or follow up stent patency. Graphical Abstract

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Section: Resultsmentioning

confidence: 99%

Coronary chronic total occlusion on coronary CT angiography: what radiologists should know?

Xu,

Ma,

Chen

et al. 2024

Insights Imaging

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“…For example, there is continuously expanding interest to use coronary CTA in the context of percutaneous coronary intervention (PCI) (34). This includes the use of coronary CTA in the context of interventional revascularization for chronic total coronary occlusions (35)(36)(37), which has been shown to provide valuable information not readily obtainable from invasive coronary angiography. With ever more complex coronary interventions performed percutaneously, and an increasing diversity of devices available for such treatment, a growing future role of cardiac CT in the context of coronary intervention is predictable.…”

Section: Summary Of Future Perspectivesmentioning

confidence: 99%

Coronary CT angiography—future directions

Achenbach

2017

Cardiovasc. Diagn. Ther.

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Clinical applications of coronary CT angiography (CTA) will typically be based on the method´s very high sensitivity to identify coronary stenosis if image quality is good and if the pre-test likelihood of the patients is in the lower range. Guidelines of national and international cardiac societies are starting to incorporate coronary CTA into their recommendations for the management of patients with stable and acute chest pain. Initial data show that in the future, the use of coronary CTA may not only be able to replace other forms of diagnostic testing, but, in fact, may improve patient outcome. In this article, a perspective is provided on the future directions of coronary CTA.

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How to Manage Radiation and Contrast During Chronic Total Occlusion Percutaneous Coronary Intervention

Kaier

Pavlidis

Smith

2022

Percutaneous Coronary Intervention for Chronic Total Occlusion

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Visualization of collateral channels with coronary computed tomography angiography for the retrograde approach in percutaneous coronary intervention for chronic total occlusion

Abstract: Coronary CTA provides good visualization of collaterals used in retrograde CTO PCI. For retrograde guidewire crossing, a higher success rate with fewer complications was observed in CTA-visible collaterals than in those not detectable in coronary CTA.

Cited by 7 publications

References 30 publications

Coronary chronic total occlusion on coronary CT angiography: what radiologists should know?

Coronary chronic total occlusion on coronary CT angiography: what radiologists should know?

Coronary CT angiography—future directions

How to Manage Radiation and Contrast During Chronic Total Occlusion Percutaneous Coronary Intervention

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