Real-time fusion of coronary CT angiography with x-ray fluoroscopy during chronic total occlusion PCI

Brian B. Ghoshhajra, Richard A P Takx, Luke L. Stone, Erin E. Girard, Emmanouil S. Brilakis, William L. Lombardi, Robert W. Yeh, Farouc A. Jaffer

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objectives: The purpose of this study was to demonstrate the feasibility of real-time fusion of coronary computed tomography angiography (CTA) centreline and arterial wall calcification with x-ray fluoroscopy during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Methods: Patients undergoing CTO PCI were prospectively enrolled. Pre-procedural CT scans were integrated with conventional coronary fluoroscopy using prototype software. We enrolled 24 patients who underwent CTO PCI using the prototype CT fusion software, and 24 consecutive CTO PCI patients without CT guidance served as a control group. Results: Mean age was 66 ± 11 years, and 43/48 patients were men. Real-time CTA fusion during CTO PCI provided additional information regarding coronary arterial calcification and tortuosity that generated new insights into antegrade wiring, antegrade dissection/reentry, and retrograde wiring during CTO PCI. Overall CTO success rates and procedural outcomes remained similar between the two groups, despite a trend toward higher complexity in the fusion CTA group. Conclusions: This study demonstrates that real-time automated co-registration of coronary CTA centreline and calcification onto live fluoroscopic images is feasible and provides new insights into CTO PCI, and in particular, antegrade dissection reentry-based CTO PCI. Key Points: • Real-time semi-automated fusion of CTA/fluoroscopy is feasible during CTO PCI.• CTA fusion data can be toggled on/off as desired during CTO PCI• Real-time CT calcium and centreline overlay could benefit antegrade dissection/reentry-based CTO PCI.

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
JournalEuropean Radiology
DOIs
StateAccepted/In press - Sep 23 2016

Fingerprint

Fluoroscopy
Percutaneous Coronary Intervention
Coronary Angiography
X-Rays
Dissection
Computed Tomography Angiography
Software
Calcium

Keywords

  • Atherosclerosis
  • Automatic data processing
  • Coronary angiography
  • Multidetector computed tomography
  • Percutaneous coronary intervention

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Ghoshhajra, B. B., Takx, R. A. P., Stone, L. L., Girard, E. E., Brilakis, E. S., Lombardi, W. L., ... Jaffer, F. A. (Accepted/In press). Real-time fusion of coronary CT angiography with x-ray fluoroscopy during chronic total occlusion PCI. European Radiology, 1-10. https://doi.org/10.1007/s00330-016-4599-5

Real-time fusion of coronary CT angiography with x-ray fluoroscopy during chronic total occlusion PCI. / Ghoshhajra, Brian B.; Takx, Richard A P; Stone, Luke L.; Girard, Erin E.; Brilakis, Emmanouil S.; Lombardi, William L.; Yeh, Robert W.; Jaffer, Farouc A.

In: European Radiology, 23.09.2016, p. 1-10.

Research output: Contribution to journalArticle

Ghoshhajra, Brian B. ; Takx, Richard A P ; Stone, Luke L. ; Girard, Erin E. ; Brilakis, Emmanouil S. ; Lombardi, William L. ; Yeh, Robert W. ; Jaffer, Farouc A. / Real-time fusion of coronary CT angiography with x-ray fluoroscopy during chronic total occlusion PCI. In: European Radiology. 2016 ; pp. 1-10.
@article{17c2b1dbb390402db8e05695968e8d54,
title = "Real-time fusion of coronary CT angiography with x-ray fluoroscopy during chronic total occlusion PCI",
abstract = "Objectives: The purpose of this study was to demonstrate the feasibility of real-time fusion of coronary computed tomography angiography (CTA) centreline and arterial wall calcification with x-ray fluoroscopy during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Methods: Patients undergoing CTO PCI were prospectively enrolled. Pre-procedural CT scans were integrated with conventional coronary fluoroscopy using prototype software. We enrolled 24 patients who underwent CTO PCI using the prototype CT fusion software, and 24 consecutive CTO PCI patients without CT guidance served as a control group. Results: Mean age was 66 ± 11 years, and 43/48 patients were men. Real-time CTA fusion during CTO PCI provided additional information regarding coronary arterial calcification and tortuosity that generated new insights into antegrade wiring, antegrade dissection/reentry, and retrograde wiring during CTO PCI. Overall CTO success rates and procedural outcomes remained similar between the two groups, despite a trend toward higher complexity in the fusion CTA group. Conclusions: This study demonstrates that real-time automated co-registration of coronary CTA centreline and calcification onto live fluoroscopic images is feasible and provides new insights into CTO PCI, and in particular, antegrade dissection reentry-based CTO PCI. Key Points: • Real-time semi-automated fusion of CTA/fluoroscopy is feasible during CTO PCI.• CTA fusion data can be toggled on/off as desired during CTO PCI• Real-time CT calcium and centreline overlay could benefit antegrade dissection/reentry-based CTO PCI.",
keywords = "Atherosclerosis, Automatic data processing, Coronary angiography, Multidetector computed tomography, Percutaneous coronary intervention",
author = "Ghoshhajra, {Brian B.} and Takx, {Richard A P} and Stone, {Luke L.} and Girard, {Erin E.} and Brilakis, {Emmanouil S.} and Lombardi, {William L.} and Yeh, {Robert W.} and Jaffer, {Farouc A.}",
year = "2016",
month = "9",
day = "23",
doi = "10.1007/s00330-016-4599-5",
language = "English (US)",
pages = "1--10",
journal = "European Radiology",
issn = "0938-7994",
publisher = "Springer Verlag",

}

TY - JOUR

T1 - Real-time fusion of coronary CT angiography with x-ray fluoroscopy during chronic total occlusion PCI

AU - Ghoshhajra, Brian B.

AU - Takx, Richard A P

AU - Stone, Luke L.

AU - Girard, Erin E.

AU - Brilakis, Emmanouil S.

AU - Lombardi, William L.

AU - Yeh, Robert W.

AU - Jaffer, Farouc A.

PY - 2016/9/23

Y1 - 2016/9/23

N2 - Objectives: The purpose of this study was to demonstrate the feasibility of real-time fusion of coronary computed tomography angiography (CTA) centreline and arterial wall calcification with x-ray fluoroscopy during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Methods: Patients undergoing CTO PCI were prospectively enrolled. Pre-procedural CT scans were integrated with conventional coronary fluoroscopy using prototype software. We enrolled 24 patients who underwent CTO PCI using the prototype CT fusion software, and 24 consecutive CTO PCI patients without CT guidance served as a control group. Results: Mean age was 66 ± 11 years, and 43/48 patients were men. Real-time CTA fusion during CTO PCI provided additional information regarding coronary arterial calcification and tortuosity that generated new insights into antegrade wiring, antegrade dissection/reentry, and retrograde wiring during CTO PCI. Overall CTO success rates and procedural outcomes remained similar between the two groups, despite a trend toward higher complexity in the fusion CTA group. Conclusions: This study demonstrates that real-time automated co-registration of coronary CTA centreline and calcification onto live fluoroscopic images is feasible and provides new insights into CTO PCI, and in particular, antegrade dissection reentry-based CTO PCI. Key Points: • Real-time semi-automated fusion of CTA/fluoroscopy is feasible during CTO PCI.• CTA fusion data can be toggled on/off as desired during CTO PCI• Real-time CT calcium and centreline overlay could benefit antegrade dissection/reentry-based CTO PCI.

AB - Objectives: The purpose of this study was to demonstrate the feasibility of real-time fusion of coronary computed tomography angiography (CTA) centreline and arterial wall calcification with x-ray fluoroscopy during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Methods: Patients undergoing CTO PCI were prospectively enrolled. Pre-procedural CT scans were integrated with conventional coronary fluoroscopy using prototype software. We enrolled 24 patients who underwent CTO PCI using the prototype CT fusion software, and 24 consecutive CTO PCI patients without CT guidance served as a control group. Results: Mean age was 66 ± 11 years, and 43/48 patients were men. Real-time CTA fusion during CTO PCI provided additional information regarding coronary arterial calcification and tortuosity that generated new insights into antegrade wiring, antegrade dissection/reentry, and retrograde wiring during CTO PCI. Overall CTO success rates and procedural outcomes remained similar between the two groups, despite a trend toward higher complexity in the fusion CTA group. Conclusions: This study demonstrates that real-time automated co-registration of coronary CTA centreline and calcification onto live fluoroscopic images is feasible and provides new insights into CTO PCI, and in particular, antegrade dissection reentry-based CTO PCI. Key Points: • Real-time semi-automated fusion of CTA/fluoroscopy is feasible during CTO PCI.• CTA fusion data can be toggled on/off as desired during CTO PCI• Real-time CT calcium and centreline overlay could benefit antegrade dissection/reentry-based CTO PCI.

KW - Atherosclerosis

KW - Automatic data processing

KW - Coronary angiography

KW - Multidetector computed tomography

KW - Percutaneous coronary intervention

UR - http://www.scopus.com/inward/record.url?scp=84988734696&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84988734696&partnerID=8YFLogxK

U2 - 10.1007/s00330-016-4599-5

DO - 10.1007/s00330-016-4599-5

M3 - Article

C2 - 27663227

AN - SCOPUS:84988734696

SP - 1

EP - 10

JO - European Radiology

JF - European Radiology

SN - 0938-7994

ER -