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Publications

Journal Article Review Ahead of print

PubMed: 42069285 DOI: 10.1016/j.amjcard.2026.04.045

Systematic Review of Coronary Computed Tomography Angiography Guidance for Chronic Total Occlusion Percutaneous Coronary Intervention.

Am J Cardiol

Authors: Sant Kumar, Pedro E P Carvalho, Dimitrios Strepkos, Michaella Alexandrou, Maksymilian P Opolski, Lorenzo Azzalini, Khaldoon Alaswad, Mir B Basir, Farouc Jaffer, Carlos Collet, Jonathon Leipsic, Joao Cavalcante, Bavana V Rangan, Yader Sandoval, Emmanouil S Brilakis

Affiliations

  • Creighton University School of Medicine, Phoenix, AZ, USA.
  • Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.
  • Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland.
  • Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA.
  • Henry Ford Cardiovascular Division, Detroit, MI, USA.
  • Massachusetts General Hospital, Boston, MA, USA.
  • Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium.
  • Department of Medicine and Radiology, University of British Columbia, Vancouver, BC, Canada.
  • Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.

Abstract

Coronary computed tomography angiography (CCTA) is emerging as a valuable adjunct for chronic total occlusion (CTO) percutaneous coronary intervention (PCI), particularly for lesions in which angiography incompletely defines procedural anatomy. In this systematic review, the authors evaluated the role of CCTA in CTO diagnosis, lesion characterization, prediction of guidewire crossing and procedural success, and procedural guidance. CCTA provides a detailed assessment of key features that directly influence CTO PCI strategy and outcomes. Randomized and observational data suggest that preprocedural CCTA can improve procedural planning, increase technical success in complex lesions, and support safer and more efficient CTO PCI through fluoroscopic co-registration and other real-time guidance applications. These findings highlight the clinical value of CCTA as a tool that can enhance case selection, optimize crossing strategy, and improve procedural success in contemporary CTO PCI.

MeSH

Tomography, Percutaneous Coronary Intervention, Angiography, Wounds And Injuries, Computed Tomography Angiography