The Role of Intravascular Imaging in Coronary Chronic Total Occlusion PCI: Enhancing Procedural Success Through Real-Time Visualization

Hussein Sliman; Rim Kasem Ali Sliman; Paul Knaapen; Alex Nap; Grzegorz Sobieszek; Maksymilian P. Opolski

doi:10.3390/jpm15070318

The Role of Intravascular Imaging in Coronary Chronic Total Occlusion PCI: Enhancing Procedural Success Through Real-Time Visualization

Hussein Sliman
, Rim Kasem Ali Sliman^*
, Paul Knaapen
, Alex Nap
, Grzegorz Sobieszek
, Maksymilian P. Opolski

^*Corresponding author for this work

Technion-Israel Institute of Technology
Carmel Medical Center
University of Amsterdam
Wojskowy Szpital Kliniczny z Polikliniką SP ZOZ w Lublinie
Cardinal Stefan Wyszynski Institute of Cardiology

Research output: Contribution to journal › Review article › Academic › peer-review

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Abstract

Coronary chronic total occlusions (CTOs) are diagnosed in a significant portion of patients undergoing coronary angiography and represent one of the most complex scenarios in contemporary percutaneous coronary interventions (PCI). This review systematically examines how adjunctive imaging modalities’—intravascular ultrasound (IVUS), optical coherence tomography (OCT), and coronary computed tomography angiography (CCTA)—co-registration enhances the precision and success rates of CTO-PCI during the procedure. The strategic integration of these technologies enables the development of patient-specific intervention strategies tailored to individual vascular architecture and lesion characteristics. This personalized approach marks a transition from standardized protocols to precision interventional cardiology, potentially optimizing procedural success rates while minimizing complications.

Original language	English
Article number	318
Journal	Journal of personalized medicine
Volume	15
Issue number	7
DOIs	https://doi.org/10.3390/jpm15070318
Publication status	Published - 1 Jul 2025

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

chronic total occlusion (CTO)
coronary computed tomography angiography (CCTA)
intravascular ultrasound (IVUS)
optical coherence tomography (OCT)
percutaneous coronary intervention (PCI)

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title = "The Role of Intravascular Imaging in Coronary Chronic Total Occlusion PCI: Enhancing Procedural Success Through Real-Time Visualization",

abstract = "Coronary chronic total occlusions (CTOs) are diagnosed in a significant portion of patients undergoing coronary angiography and represent one of the most complex scenarios in contemporary percutaneous coronary interventions (PCI). This review systematically examines how adjunctive imaging modalities{\textquoteright}—intravascular ultrasound (IVUS), optical coherence tomography (OCT), and coronary computed tomography angiography (CCTA)—co-registration enhances the precision and success rates of CTO-PCI during the procedure. The strategic integration of these technologies enables the development of patient-specific intervention strategies tailored to individual vascular architecture and lesion characteristics. This personalized approach marks a transition from standardized protocols to precision interventional cardiology, potentially optimizing procedural success rates while minimizing complications.",

keywords = "chronic total occlusion (CTO), coronary computed tomography angiography (CCTA), intravascular ultrasound (IVUS), optical coherence tomography (OCT), percutaneous coronary intervention (PCI)",

author = "Hussein Sliman and \{Kasem Ali Sliman\}, Rim and Paul Knaapen and Alex Nap and Grzegorz Sobieszek and Opolski, \{Maksymilian P.\}",

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doi = "10.3390/jpm15070318",

language = "English",

volume = "15",

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T2 - Enhancing Procedural Success Through Real-Time Visualization

AU - Sliman, Hussein

AU - Kasem Ali Sliman, Rim

AU - Knaapen, Paul

AU - Nap, Alex

AU - Sobieszek, Grzegorz

AU - Opolski, Maksymilian P.

PY - 2025/7/1

Y1 - 2025/7/1

N2 - Coronary chronic total occlusions (CTOs) are diagnosed in a significant portion of patients undergoing coronary angiography and represent one of the most complex scenarios in contemporary percutaneous coronary interventions (PCI). This review systematically examines how adjunctive imaging modalities’—intravascular ultrasound (IVUS), optical coherence tomography (OCT), and coronary computed tomography angiography (CCTA)—co-registration enhances the precision and success rates of CTO-PCI during the procedure. The strategic integration of these technologies enables the development of patient-specific intervention strategies tailored to individual vascular architecture and lesion characteristics. This personalized approach marks a transition from standardized protocols to precision interventional cardiology, potentially optimizing procedural success rates while minimizing complications.

AB - Coronary chronic total occlusions (CTOs) are diagnosed in a significant portion of patients undergoing coronary angiography and represent one of the most complex scenarios in contemporary percutaneous coronary interventions (PCI). This review systematically examines how adjunctive imaging modalities’—intravascular ultrasound (IVUS), optical coherence tomography (OCT), and coronary computed tomography angiography (CCTA)—co-registration enhances the precision and success rates of CTO-PCI during the procedure. The strategic integration of these technologies enables the development of patient-specific intervention strategies tailored to individual vascular architecture and lesion characteristics. This personalized approach marks a transition from standardized protocols to precision interventional cardiology, potentially optimizing procedural success rates while minimizing complications.

KW - chronic total occlusion (CTO)

KW - coronary computed tomography angiography (CCTA)

KW - intravascular ultrasound (IVUS)

KW - optical coherence tomography (OCT)

KW - percutaneous coronary intervention (PCI)

UR - https://www.scopus.com/pages/publications/105011671681

U2 - 10.3390/jpm15070318

DO - 10.3390/jpm15070318

M3 - Review article

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ER -

The Role of Intravascular Imaging in Coronary Chronic Total Occlusion PCI: Enhancing Procedural Success Through Real-Time Visualization

Abstract

UN SDGs

Keywords

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