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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