title: Utility of Intravascular Ultrasound in Percutaneous Revascularization of Chronic Total Occlusions: An Overview.
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.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Catania, Italy; University Heart Center, University Hospital Zurich Switzerland. Electronic address: argalassi@gmail.com.
authors.forename: Alfredo R
authors.initials: AR
authors.lastname: Galassi
authors.affiliation: Internal Division of Cardiology for Education and Research Osaka University, Osaka, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Sumitsuji
authors.affiliation: Department of Clinical and Experimental Medicine, University of Catania, Italy; Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
authors.forename: Marouane
authors.initials: M
authors.lastname: Boukhris
authors.affiliation: Veterans Administration North Texas Healthcare System and University of Texas Southwestern Medical School, Dallas, Texas.
authors.forename: Emmanouil S
authors.initials: ES
authors.lastname: Brilakis
authors.affiliation: NIHR Cardiovascular BRU Royal Brompton Hospital & National Heart and Lung Institute, Imperial College London, London, United Kingdom.
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Mario
authors.affiliation: Policlinico San Giovanni Bosco, Turin, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Garbo
authors.affiliation: Department of Cardiology, Forth Valley Royal Hospital, Larbert, United Kingdom.
authors.forename: James C
authors.initials: JC
authors.lastname: Spratt
authors.affiliation: Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark.
authors.forename: Evald H
authors.initials: EH
authors.lastname: Christiansen
authors.affiliation: Department of Cardiology, Infermi Hospital, Rivoli, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Gagnor
authors.affiliation: Clinique Générale de Marignane, Marseille, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Avran
authors.affiliation: Department of Cardiology, American Hellenic Educational Progressive Association University Hospital, Thessaloniki, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Sianos
authors.affiliation: Medizinische Klinik I (Cardiology & Intensive Care), Klinikum Darmstadt GmbH, Darmstadt, Germany.
authors.forename: Gerald S
authors.initials: GS
authors.lastname: Werner
mesh_terms: D062906:Cardiac Catheters; D002908:Chronic Disease; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000000981:diagnostic imaging* / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D006801:Humans; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D011237:Predictive Value of Tests; D015607:Stents; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
keywords: PCI; chronic total occlusions; intracoronary imaging; intravascular ultrasound