title: Value of Hybrid Imaging with PET/CT to Guide Percutaneous Revascularization of Chronic Total Coronary Occlusion.
abstract: Chronic total coronary occlusions (CTO) are documented in approximately one fifth of diagnostic invasive coronary angiographies (ICA). Percutaneous coronary interventions (PCI) of CTO are challenging and are accompanied by higher complication and lower success rates in comparison with non-CTO PCI. Scrutinous evaluation of ischemia and viability to justify percutaneous revascularization is therefore of importance to select eligible patients for such a procedure. Furthermore, knowledge of the anatomical features of the occlusion may predict the chances of success of PCI CTO and could even guide the procedural strategy to augment the likelihood of recanalization. Positron emission tomography (PET) is unequivocally accepted as the reference standard for ischemia and viability testing, whereas coronary computed tomography angiography (CCTA) currently allows for non-invasive detailed three-dimensional imaging of the coronary anatomy that adds morphological information over two-dimensional ICA. Hybrid PET/CT could therefore be useful for optimal patient selection as well as procedural planning. This review discusses the potential value of PET/CT to guide PCI in CTOs.
authors.affiliation: Department of Cardiology, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
authors.forename: Wijnand J
authors.initials: WJ
authors.lastname: Stuijfzand
authors.affiliation: Radiology & Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Pieter G
authors.initials: PG
authors.lastname: Raijmakers
authors.affiliation: Department of Cardiology, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
authors.forename: Roel S
authors.initials: RS
authors.lastname: Driessen
authors.affiliation: Department of Cardiology, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
authors.forename: Niels
authors.initials: N
authors.lastname: van Royen
authors.affiliation: Department of Cardiology, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
authors.forename: Alexander
authors.initials: A
authors.lastname: Nap
authors.affiliation: Department of Cardiology, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
authors.forename: Albert C
authors.initials: AC
authors.lastname: van Rossum
authors.affiliation: Department of Cardiology, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: Knaapen
keywords: Chronic total occlusion; Coronary artery disease; Coronary computed tomography angiography; Invasive coronary angiography; Percutaneous coronary intervention; Positron emission tomography