The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Current evidence for prognostic benefit of intravascular imaging-guided percutaneous coronary intervention in chronic total occlusion intervention

  • David Hong (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Sung Eun Kim (Department of Internal Medicine, Inje University Ilsan Paik Hospital) ;
  • Seung Hun Lee (Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Seung-Jae Lee (Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Jong-Young Lee (Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine) ;
  • Sang Min Kim (Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine) ;
  • Sang Yeub Lee (Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine) ;
  • Woochan Kwon (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Ki Hong Choi (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Taek Kyu Park (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jeong Hoon Yang (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Young Bin Song (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Seung-Hyuk Choi (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Hyeon-Cheol Gwon (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Joo-Yong Hahn (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Joo Myung Lee (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2023.10.04
  • Accepted : 2023.11.16
  • Published : 2024.09.01
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Abstract

Although percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) has been increasing in recent years, CTO PCI is still one of the most challenging procedures with relatively higher rates of procedural complications and adverse clinical events after PCI. Due to the innate limitations of invasive coronary angiography, intravascular imaging (IVI) has been used as an adjunctive tool to complement PCI, especially in complex coronary artery disease. Considering the complexity of CTO lesions, the role of IVI is particularly important in CTO intervention. IVI has been a useful adjunctive tool in every step of CTO PCI including assisted wire crossing, confirmation of wire location within CTO segment, and stent optimization. The meticulous use of IVI has been one of the greatest contributors to recent progress of CTO PCI. Nevertheless, studies evaluating the role of IVI during CTO PCI are limited. The current review provides a comprehensive overview of the mechanistic advantages of IVI in CTO PCI, summarizes previous studies and trials, and presents future perspective of IVI in CTO PCI.

Keywords

Acknowledgement

The RENOVATE-COMPLEX-PCI trial is investigator-initiated with grant support from Abbott Vascular and Boston Scientific. Other than providing financial support, the sponsors were not involved with protocol development or the study process, including site selection, study management, data collection, and analysis of the results.

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