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Updated: Jul 26, 2026
Imaging In-Stent Restenosis: An Inexpensive, Reliable, and Rapid Preclinical Model
Published on: September 14, 2009
Current evidence for prognostic benefit of intravascular imaging-guided percutaneous coronary intervention in chronic
David Hong1, Sung Eun Kim2, Seung Hun Lee3
1Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Insights
Intravascular imaging (IVI) significantly enhances percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) by improving guidewire navigation and stent placement. This review highlights IVI
Area of Science:
- Cardiovascular Interventions
- Medical Imaging
- Interventional Cardiology
Background:
- Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) remains challenging.
- Limitations of coronary angiography necessitate advanced imaging techniques.
- Intravascular imaging (IVI) offers complementary insights in complex coronary artery disease.
Purpose of the Study:
- To review the mechanistic advantages of IVI in CTO PCI.
- To summarize existing studies and trials on IVI in CTO PCI.
- To discuss the future perspectives of IVI for CTO intervention.
Main Methods:
- Comprehensive literature review of studies and trials.
- Analysis of IVI's role in various stages of CTO PCI.
- Synthesis of current evidence and future directions.
Main Results:
- IVI aids in guidewire crossing and confirmation of location within CTO lesions.
- IVI facilitates optimal stent deployment and lesion assessment.
- Meticulous IVI use has contributed to advancements in CTO PCI outcomes.
Conclusions:
- IVI is a crucial adjunctive tool in CTO PCI, improving procedural success and safety.
- Further research is needed to fully elucidate the impact of IVI in CTO interventions.
- IVI holds significant promise for advancing the field of complex CTO PCI.
Abstract:
Although percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) has been increasing in recent years, CTO PCI is still one of the most challenging procedures with relatively higher rates of procedural complications and adverse clinical events after PCI. Due to the innate limitations of invasive coronary angiography, intravascular imaging (IVI) has been used as an adjunctive tool to complement PCI, especially in complex coronary artery disease. Considering the complexity of CTO lesions, the role of IVI is particularly important in CTO intervention. IVI has been a useful adjunctive tool in every step of CTO PCI including assisted wire crossing, confirmation of wire location within CTO segment, and stent optimization. The meticulous use of IVI has been one of the greatest contributors to recent progress of CTO PCI. Nevertheless, studies evaluating the role of IVI during CTO PCI are limited. The current review provides a comprehensive overview of the mechanistic advantages of IVI in CTO PCI, summarizes previous studies and trials, and presents future perspective of IVI in CTO PCI.
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