Non-invasive imaging techniques in patients with coronary chronic total occlusions: A key for successful diagnosis, revascularization, and post-intervention outcomes

Cardiol J. 2023 May 11;30(6):1038-1048. doi: 10.5603/CJ.a2023.0028. Online ahead of print.

Abstract

Coronary chronic total occlusions (CTOs) are a common finding on coronary angiograms of patients with coronary artery disease, with an incidence ranging from 15% to 25%. Despite this high incidence, the proper treatment strategy in those patients often remains unclear. There are some observational studies suggesting that successful revascularization of a CTO can reduce angina symptoms, improve quality of life, improve the left ventricular ejection fraction, and lower mortality. However, not all patients will benefit from revascularization. Pre-procedural assessment of left ventricular function, ischemic burden, and viability seems to be crucial for a good outcome of the revascularization. The aim of this review is to compare currently available non-invasive imaging modalities with regard to utility in evaluation of patients with CTOs.

Keywords: angiography; cardiac magnetic resonance; computed tomography; coronary artery disease; coronary chronic total occlusions; echocardiography; positron emission tomography; single-photon emission computed tomography.