Coronary interventions

Computed tomography angiography co-registration with real-time fluoroscopy in percutaneous coronary intervention for chronic total occlusions

EuroIntervention 2021;17:433-435. DOI: 10.4244/EIJ-D-20-00175

Iosif Xenogiannis
Iosif Xenogiannis1, MD, PhD; Farouc A. Jaffer2, MD, PhD; Alpesh R. Shah3, MD; Mohamed Omer1, MD; Michael Megaly1, MD; Evangelia Vemmou1, MD; Ilias Nikolakopoulos1, MD; Bavana Rangan V.1, BDS, MPH; Santiago Garcia1, MD; John R. Lesser1, MD; João L. Cavalcante1, MD; M. Nicholas Burke1, MD; Emmanouil S. Brilakis1, MD, PhD
1. Center for Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern, Minneapolis, MN, USA; 2. Interventional Cardiology Department, Massachusetts General Hospital, Boston, MA, USA; 3. Interventional Cardiology Department, Houston Methodist Hospital, Houston, TX, USA

Preprocedural coronary computed tomography angiography (CTA) can identify calcification and tortuosity, and accurately determine the occlusion length, which may facilitate chronic total occlusion (CTO) crossing. A major limitation of offline CTA is lack of real-time guidance during percutaneous coronary intervention (PCI). This limitation can be overcome using CTA co-registration with a real-time fluoroscopy system.


CTA/fluoroscopy fusion was used in 27 of 146 cases (18%) performed in 2018-2019, by two experienced operators, at two centres participating in the PROGRESS-CTO registry (NCT02061436). We compared the clinical, angiographic and technical characteristics and procedural outcomes of the patients who underwent CTO ...

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