Optical frequency domain imaging guided crossing of a stumpless chronic total occlusion

Abstract Chronic total occlusions (CTO) pose significant challenges for interventional cardiologists. The most common cause of procedural failure of percutaneous coronary intervention (PCI) for CTOs is the inability to cross the occlusion with a guidewire. Stumpless CTOs, where occlusion of a branch is flush with main vessel, make this crucial step much more difficult. We report a successful attempt at recanalizing a stumpless CTO, where novel optical-frequency domain imaging (OFDI) guidance precisely showed the entry point and facilitated entry of the true lumen with a stiff wire.