Interv Cardiol Clin. 2026 Jan;15(1):111-120. doi: 10.1016/j.iccl.2025.09.011. Epub 2025 Oct 23.
ABSTRACT
Percutaneous coronary intervention (PCI) of chronic total occlusions (CTO) presents a technical challenge. Some of these challenges may be mitigated by the use of intravascular imaging (IVI). IVI provides additional details uniquely relevant to CTO-PCI, including facilitating guidewire passage of ambiguous cap, determination of the intra- or extra-plaque path of the guidewire, and visualization of overlapping guidewires in reverse controlled antegrade and retrograde subintimal tracking. In this review, we provide an overview of IVI in CTO-PCI, highlighting its utility in specific clinical scenarios and discuss areas that require technical advances and investigation in the context of current barriers for adoption.
PMID:41276386 | DOI:10.1016/j.iccl.2025.09.011