Ex vivo imaging of chronic total occlusions using forward‐looking optical coherence tomography

@article{Munce2007ExVI,
  title={Ex vivo imaging of chronic total occlusions using forward‐looking optical coherence tomography},
  author={Nigel R. Munce and Victor X. D. Yang and Beau A. Standish and Beiping Qiang and Jagdish W. Butany and Brian K. Courtney and John J. Graham and Alexander Dick and Bradley H. Strauss and Graham A. Wright and I. Alex Vitkin},
  journal={Lasers in Surgery and Medicine},
  year={2007},
  volume={39}
}
Percutaneous coronary interventions (PCI) of chronic total occlusions (CTOs) of arteries are more challenging lesions to treat with angioplasty and stenting than stenotic vessels due primarily to the difficulty in guiding the wire across the lesion. Angiography alone is unable to differentiate between the occluded lumen and the vessel wall and to characterize the content of the occlusion. New technologies to aid in interventional guidance are therefore highly desirable. We sought to evaluate… 
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Innovations in imaging for chronic total occlusions: a glimpse into the future of angiography's blind-spot.
TLDR
This review describes the current status of several invasive and non-invasive imaging techniques that may facilitate improved image guidance during CTO revascularization, with the goals of improving procedure safety and efficacy while reducing the time required to complete these interventions.
Intracoronary imaging in chronic total occlusions
Chronic total occlusion (CTO) intervention constitutes approximately 10–20% of all angioplasty procedures at selected centers. Benefits of CTO revascularization, in addition to relief of angina,…
The role of adjunctive imaging in chronic total occlusions
TLDR
Preprocedural preparation including patient selection and detailed coronary imaging with the use of computerized tomography are helpful to ensure the highest chance of success in chronic total occlusion percutaneous intervention.
Doppler optical coherence tomography for interventional cardiovascular guidance: in vivo feasibility and forward-viewing probe flow phantom demonstration.
TLDR
The potential of a forward-looking Doppler optical coherence tomography (OCT) probe for color flow imaging in several commonly seen narrowed artery morphologies is demonstrated and flow phantoms consisting of small channels and tapered entrance geometries are demonstrated.
The potential of optical coherence tomography for intravascular imaging of chronic total occlusions.
This thesis presents the first work, to our knowledge, to evaluate the potential of Optical Coherence Tomography (OCT) as an intravascular imaging modality to characterize and guide interventions on…
Multimodality Image-Guided Cardiovascular Intervention
TLDR
Applications of multimodality image-guidance discussed in this article include traversing chronic total occlusions (CTO), regeneration of infarcted myocardium, catheter-based ablation procedures and various pediatric cardiovascular interventions.
Development of Methods for the MR-guided Percutaneous Revascularization of Chronic Total Occlusions
TLDR
Methods are developed that enable the percutaneous revascularization of occlusive lesions to be guided using magnetic resonance (MR) imaging to provide valuable information regarding the composition and geometry of the lesion.
Optical coherence tomography for guiding wire into a side branch coronary artery with flush total occlusion.
Current considerations regarding the percutaneous revascularization of chronic total coronary occlusions
TLDR
Advances in technique and equipment have resulted in improved success rates that now approach 90% at specialized centers, and it remains to be seen if these positive results can be achieved by the interventional cardiology community at large.
Collagenase Total Occlusion-1 (CTO-1) Trial: A Phase I, Dose-Escalation, Safety Study
TLDR
Local delivery of collagenase into coronary chronic total occlusion is feasible and safe with encouraging guide wire crossing results in previously failed cases, and larger clinical trials are required to determine efficacy.
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References

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