Letters to the editor

Letter: How should coronary computed tomography angiography co-registration be applied in the chronic total occlusion hybrid algorithm?

EuroIntervention 2021;16:1372-1373. DOI: 10.4244/EIJ-D-20-00924L

Maksymilian Opolski
Maksymilian P. Opolski1, MD, PhD; Paul Knaapen1, MD, PhD
1. Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland


We read with great interest the paper by Xenogiannis et al regarding their initial experience with real-time coronary computed tomography angiography (coronary CTA)/fluoroscopy fusion guidance for chronic total occlusion (CTO) percutaneous coronary intervention (PCI)1. While their observations are interesting, we would like to raise some important points regarding the practical use of CTA co-registration for CTO PCI using the hybrid algorithm.

First, whereas the second most common indication (56%) for CTA/fluoroscopy fusion in the study by Xenogiannis et al was to facilitate intra-CTO wire advancement, coronary CTA cannot reliably differentiate between intraluminal and subintimal guidewire position2. Specifically, ...

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