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Current Cardiology Reviews

Editor-in-Chief

ISSN (Print): 1573-403X
ISSN (Online): 1875-6557

Intravascular Ultrasound Guided Percutaneous Coronary Intervention for Chronic Total Occlusion

Author(s): Debabrata Dash and Li Li

Volume 11, Issue 4, 2015

Page: [323 - 327] Pages: 5

DOI: 10.2174/1573403X11666150909105827

Price: $65

Abstract

Chronic total occlusion (CTO), a fascinating and dynamic niche in the realm of coronary artery disease, represents a major technical challenge for interventional cardiologists despite evolution of better guidewires, devices, experience and techniques. Effective wiring technique is the corner stone to success of percutaneous coronary intervention (PCI) in CTO. As a guide for guidewire crossing in CTO, coronary angiography is limited. On the other hand, intravascular ultrasound (IVUS) enhances the ability to identify coronary anatomy, the exact location of the guidewires within an artery, discriminating a true lumen from the false lumen before guidewire crossing. Some angiographic features have been suggested to be predictive of procedural failure, including blunt stump with a side branch at the site of occlusion. Novel use of IVUS can recognize the optimal entry point and evaluate if a guidewire properly penetrates the proximal cap of CTO.

Keywords: Chronic total occlusion, intravascular ultrasound, percutaneous coronary intervention.

Graphical Abstract

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