Chronic total coronary occlusions (CTO) are found frequently in coronary artery disease; however, the technical challenge to open the occlusion by percutaneous coronary intervention is considerably higher than for nonocclusive lesions. The angiographic analysis is limited by the inability to visualize the occluded segment and requires a dual injection approach from donor and recipient vessel to assess the CTO. Therefore, imaging of the CTO by computed tomographic angiography can provide additional information on the vessel course within the CTO segment, specifically the degree and extent of calcification, and maybe even be superior to angiography to analyze the proximal cap morphology. This had been integrated in a score to predict the interventional success. This information provides a valuable means to better plan the procedure and the required strategy. In addition, an integration of the computed tomographic angiography is possible by synchronization with the gantry position and movement of the angiography system during percutaneous coronary intervention, illustrating the course of the occluded segment and possible obstacles in the way. It remains to be established which patient will most likely profit from this additional preprocedural examination involving increased radiation and contrast media exposure and institutional expenses.

中文翻译：

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冠状动脉计算机断层血管造影术的使用，以促进经皮冠状动脉介入治疗慢性总闭塞。

在冠状动脉疾病中经常发现慢性总冠状动脉闭塞（CTO）。然而，通过经皮冠状动脉介入治疗打开闭塞的技术挑战比非闭塞性病变要高得多。血管造影分析受到无法可视化闭塞节段的限制，并且需要来自供体和受体血管的双重注射方法来评估CTO。因此，通过计算机断层血管造影术对CTO成像可以提供有关CTO段内血管走向的其他信息，特别是钙化程度和程度，甚至可能优于血管造影来分析近端帽的形态。这已被集成到一个分数中，以预测干预成功。这些信息为更好地计划程序和所需策略提供了宝贵的手段。另外，通过与经皮冠状动脉介入治疗期间血管造影系统的机架位置和运动同步，可以对计算机断层血管造影进行整合，从而说明了阻塞段的过程以及该方式中可能存在的障碍。尚有待确定哪个患者最有可能从这种额外的术前检查中受益，这些额外的术前检查涉及放射线和造影剂的暴露以及机构费用的增加。说明被遮挡的路线的过程以及可能遇到的障碍。尚有待确定哪个患者最有可能从这种额外的术前检查中受益，这种额外的术前检查涉及增加的放射线和造影剂暴露以及机构费用。说明被遮挡的路线的过程以及可能遇到的障碍。尚有待确定哪个患者最有可能从这种额外的术前检查中受益，这些额外的术前检查涉及放射线和造影剂的暴露以及机构费用的增加。