The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Letters to the editor

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

EuroIntervention 2021;16:1374-1375. DOI: 10.4244/EIJ-D-20-00924R

1. Center for Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern, Minneapolis, MN, USA


We are grateful for the insightful comments of Drs Opolski and Knaapen1. While we agree that there are multiple limitations of the existing CTA co-registration system, we would like to highlight the following:

1. “Intra-CTO wire advancement” refers to advancement within the vessel architecture (either intraplaque or subintimally) and not necessarily intraplaque. Intraplaque wire advancement cannot currently be ascertained using CTA co-registration due to low spatial resolution and limitations of the co-registered images. CTA co-registration can, however, help to determine whether the guidewire is advancing in the expected vessel course or whether it has entered a side ...

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