Document Detail


Innovations in imaging for chronic total occlusions: a glimpse into the future of angiography's blind-spot.
MedLine Citation:
PMID:  18238930     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Chronic total occlusions (CTOs) are a subset of lesions that present a considerable burden to cardiovascular patients. There exists a strong clinical desire to improve non-surgical options for CTO revascularization. While several techniques, devices, and guide wires have been developed and refined for use in CTOs, the inability of angiography to adequately visualize occluded arterial segments makes interventions in this setting technically challenging. 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. Cardiac imaging also has important potential roles in selecting patients most likely to benefit from revascularization as well as pre-procedural planning, post-procedural assessment of revascularized segments and long-term outcomes studies. Modalities discussed include non-invasive techniques, such as CT(computed tomography) angiography and cardiac magnetic resonance imaging (MRI), as well as invasive techniques, such as intravascular ultrasound, optical coherence tomography, intravascular MRI, and conventional angiography. While some of these techniques have some evidence to support their use at present, others are at earlier stages of development. Strategies that combine imaging techniques with the use of interventional therapies may provide significant opportunities to improve results in CTO interventions and represent an active area of investigation.
Authors:
Brian K Courtney; Nigel R Munce; Kevan J Anderson; Amandeep S Thind; General Leung; Perry E Radau; F Stuart Foster; I Alex Vitkin; Robert S Schwartz; Alexander J Dick; Graham A Wright; Bradley H Strauss
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2008-01-31
Journal Detail:
Title:  European heart journal     Volume:  29     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-03     Completed Date:  2008-07-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  583-93     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Schulich Heart Program, Sunnybrook Health Sciences Centre, Room A-253, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.
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MeSH Terms
Descriptor/Qualifier:
Animals
Chronic Disease
Coronary Angiography / methods
Coronary Disease / diagnosis*,  therapy
Diagnostic Imaging / methods*
Humans
Image Processing, Computer-Assisted / methods*
Magnetic Resonance Angiography / methods
Tomography, Optical Coherence / methods
Tomography, X-Ray Computed / methods
Ultrasonography, Interventional / methods

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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