The Role of Multimodality Imaging for Percutaneous Coronary Intervention in Patients With Chronic Total Occlusions
BackgroundPercutaneous coronary intervention (PCI) of Chronic total occlusions (CTOs) has been traditionally considered a challenging procedure, with a lower success rate and a higher incidence of complications compared to non-CTO-PCI. An accurate and comprehensive evaluation of potential candidates...
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| Format: | Article |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.823091/full |
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| author | Eleonora Melotti Marta Belmonte Carlo Gigante Vincenzo Mallia Saima Mushtaq Edoardo Conte Danilo Neglia Danilo Neglia Gianluca Pontone Carlos Collet Jeroen Sonck Jeroen Sonck Luca Grancini Antonio L. Bartorelli Antonio L. Bartorelli Daniele Andreini Daniele Andreini |
| author_facet | Eleonora Melotti Marta Belmonte Carlo Gigante Vincenzo Mallia Saima Mushtaq Edoardo Conte Danilo Neglia Danilo Neglia Gianluca Pontone Carlos Collet Jeroen Sonck Jeroen Sonck Luca Grancini Antonio L. Bartorelli Antonio L. Bartorelli Daniele Andreini Daniele Andreini |
| author_sort | Eleonora Melotti |
| collection | DOAJ |
| description | BackgroundPercutaneous coronary intervention (PCI) of Chronic total occlusions (CTOs) has been traditionally considered a challenging procedure, with a lower success rate and a higher incidence of complications compared to non-CTO-PCI. An accurate and comprehensive evaluation of potential candidates for CTO-PCI is of great importance. Indeed, assessment of myocardial viability, left ventricular function, individual risk profile and coronary lesion complexity as well as detection of inducible ischemia are key information that should be integrated for a shared treatment decision and interventional strategy planning. In this regard, multimodality imaging can provide combined data that can be very useful for the decision-making algorithm and for planning percutaneous CTO recanalization.AimsThe purpose of this article is to appraise the value and limitations of several non-invasive imaging tools to provide relevant information about the anatomical characteristics and functional impact of CTOs that may be useful for the pre-procedural assessment and follow-up of candidates for CTO-PCI. They include echocardiography, coronary computed tomography angiography (CCTA), nuclear imaging, and cardiac magnetic resonance (CMR). As an example, CCTA can accurately delineate CTO location and length, distal coronary bed, vessel tortuosity and calcifications that can predict PCI success, whereas stress CMR, nuclear imaging and stress-CT can provide functional evaluation in terms of myocardial ischemia and viability and perfusion defect extension. |
| first_indexed | 2024-04-14T05:17:29Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-14T05:17:29Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-4fb11d1076e24527b7d1bae472a0956c2022-12-22T02:10:20ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-05-01910.3389/fcvm.2022.823091823091The Role of Multimodality Imaging for Percutaneous Coronary Intervention in Patients With Chronic Total OcclusionsEleonora Melotti0Marta Belmonte1Carlo Gigante2Vincenzo Mallia3Saima Mushtaq4Edoardo Conte5Danilo Neglia6Danilo Neglia7Gianluca Pontone8Carlos Collet9Jeroen Sonck10Jeroen Sonck11Luca Grancini12Antonio L. Bartorelli13Antonio L. Bartorelli14Daniele Andreini15Daniele Andreini16Centro Cardiologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, ItalyCentro Cardiologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, ItalyCentro Cardiologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, ItalyCentro Cardiologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, ItalyCentro Cardiologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, ItalyCentro Cardiologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, ItalyFondazione Toscana G. Monasterio, Pisa, ItalyIstituto di Scienze della Vita Scuola Superiore Sant'Anna, Pisa, ItalyCentro Cardiologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, ItalyCardiovascular Center Aalst, OLV-Clinic, Aalst, BelgiumCardiovascular Center Aalst, OLV-Clinic, Aalst, BelgiumDepartment of Advanced Biomedical Sciences, University of Naples Federico II, Naples, ItalyCentro Cardiologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, ItalyCentro Cardiologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, ItalyDepartment of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, Milan, ItalyCentro Cardiologico Monzino, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, ItalyDepartment of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, Milan, ItalyBackgroundPercutaneous coronary intervention (PCI) of Chronic total occlusions (CTOs) has been traditionally considered a challenging procedure, with a lower success rate and a higher incidence of complications compared to non-CTO-PCI. An accurate and comprehensive evaluation of potential candidates for CTO-PCI is of great importance. Indeed, assessment of myocardial viability, left ventricular function, individual risk profile and coronary lesion complexity as well as detection of inducible ischemia are key information that should be integrated for a shared treatment decision and interventional strategy planning. In this regard, multimodality imaging can provide combined data that can be very useful for the decision-making algorithm and for planning percutaneous CTO recanalization.AimsThe purpose of this article is to appraise the value and limitations of several non-invasive imaging tools to provide relevant information about the anatomical characteristics and functional impact of CTOs that may be useful for the pre-procedural assessment and follow-up of candidates for CTO-PCI. They include echocardiography, coronary computed tomography angiography (CCTA), nuclear imaging, and cardiac magnetic resonance (CMR). As an example, CCTA can accurately delineate CTO location and length, distal coronary bed, vessel tortuosity and calcifications that can predict PCI success, whereas stress CMR, nuclear imaging and stress-CT can provide functional evaluation in terms of myocardial ischemia and viability and perfusion defect extension.https://www.frontiersin.org/articles/10.3389/fcvm.2022.823091/fullmultimodality imagingchronic total occlusion (CTO)cardiac CTcardiac magnetic resonancesingle photon emission computed tomography (SPECT)echocardiography |
| spellingShingle | Eleonora Melotti Marta Belmonte Carlo Gigante Vincenzo Mallia Saima Mushtaq Edoardo Conte Danilo Neglia Danilo Neglia Gianluca Pontone Carlos Collet Jeroen Sonck Jeroen Sonck Luca Grancini Antonio L. Bartorelli Antonio L. Bartorelli Daniele Andreini Daniele Andreini The Role of Multimodality Imaging for Percutaneous Coronary Intervention in Patients With Chronic Total Occlusions Frontiers in Cardiovascular Medicine multimodality imaging chronic total occlusion (CTO) cardiac CT cardiac magnetic resonance single photon emission computed tomography (SPECT) echocardiography |
| title | The Role of Multimodality Imaging for Percutaneous Coronary Intervention in Patients With Chronic Total Occlusions |
| title_full | The Role of Multimodality Imaging for Percutaneous Coronary Intervention in Patients With Chronic Total Occlusions |
| title_fullStr | The Role of Multimodality Imaging for Percutaneous Coronary Intervention in Patients With Chronic Total Occlusions |
| title_full_unstemmed | The Role of Multimodality Imaging for Percutaneous Coronary Intervention in Patients With Chronic Total Occlusions |
| title_short | The Role of Multimodality Imaging for Percutaneous Coronary Intervention in Patients With Chronic Total Occlusions |
| title_sort | role of multimodality imaging for percutaneous coronary intervention in patients with chronic total occlusions |
| topic | multimodality imaging chronic total occlusion (CTO) cardiac CT cardiac magnetic resonance single photon emission computed tomography (SPECT) echocardiography |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.823091/full |
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