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Chronic Total Occlusion Topic Center Clinical Images

Clinical Images
A Challenging Case of Left Main Chronic Total Occlusion and the Reverse T-Stenting and Small Protrusion (TAP) Technique: Success With the Investment Strategy
01/26/2026
Konstantinos Filippou, MD; Konstantinos Manousopoulos, MD; Panagiotis Varelas, MD; Dimitrios Karelas, MD; Ioannis Kouloulias, MD; Alexandros Zaraggas, MD; Ioannis Papadopoulos, MD; Ioannis Nenekidis, MD, PhD; Ioannis Tsiafoutis, MD, PhD
A 62-year-old man with a history of coronary artery bypass graft was referred because of worsening anginal symptoms despite being on optimal antianginal medical therapy. Physical examination, electrocardiogram, echocardiogram, and routine...
A 62-year-old man with a history of coronary artery bypass graft was referred because of worsening anginal symptoms despite being on optimal antianginal medical therapy. Physical examination, electrocardiogram, echocardiogram, and routine...
A 62-year-old man with a history...
01/26/2026
Journal of Invasive Cardiology
Clinical Images
Catch the Branch: The New Miracle Neo 3 Guidewire for Complex Bifurcation Rewiring
11/19/2025
Gabriele L. Gasparini, MD; Laura Novelli, MD; Jacopo A. Oreglia, MD; Yoshihisa Kinoshita, MD; Jorge Sanz-Sanchez, MD, PhD
A 63-year-old man with a chronic total occlusion of the right coronary artery underwent successful recanalization using a retrograde approach. After stenting, a subocclusion of the ostial posterolateral branch occurred because of plaque...
A 63-year-old man with a chronic total occlusion of the right coronary artery underwent successful recanalization using a retrograde approach. After stenting, a subocclusion of the ostial posterolateral branch occurred because of plaque...
A 63-year-old man with a chronic...
11/19/2025
Journal of Invasive Cardiology
Clinical Images
Collateral Clarity: Balloon Occlusion of an Epicardial Right Coronary Artery Branch to Map Left Anterior Descending Artery Perfusion
08/28/2025
Dimitris Karelas, MD, MSc; Konstantinos Filippou, MD, MSc; Panagiotis Varelas, MD, MSc; Konstantinos Manousopoulos, MD, PhD; Ioannis Papadopoulos, MD; Ioannis Tsiafoutis, MD, PhD
The authors present a technically informative case of a 65-year-old man referred for coronary angiography because of new onset presented angina during exercise.
The authors present a technically informative case of a 65-year-old man referred for coronary angiography because of new onset presented angina during exercise.
The authors present a...
08/28/2025
Journal of Invasive Cardiology
Clinical Images
Endovascular Management of the Radial Artery: Success Through Minimal Invasion
08/14/2025
Panagiotis Varelas, MD, MSc; Konstantinos Manousopoulos, MD, PhD; Konstantinos Filippou, MD, MSc; Dimitrios Karelas, MD, MSc; Ioannis Papadopoulos, MD; Ioannis Tsiafoutis, MD, PhD
An 84-year-old man with a history of dyslipidemia and hypertension underwent invasive coronary angiography via his right radial artery because of acute coronary syndrome. After the procedure, a palpable pulse was noted in his right forearm,...
An 84-year-old man with a history of dyslipidemia and hypertension underwent invasive coronary angiography via his right radial artery because of acute coronary syndrome. After the procedure, a palpable pulse was noted in his right forearm,...
An 84-year-old man with a...
08/14/2025
Journal of Invasive Cardiology
Clinical Images
Thrombotic Complication After a Double-Barrel Configuration Percutaneous Coronary Intervention in a Chronic Total Occlusion
07/11/2025
Panagiotis Varelas, MD, MSc; Konstantinos Manousopoulos, MD, PhD; Konstantinos Filippou, MD, MSc; Dimitrios Karelas, MD, MSc; Ioannis Papadopoulos, MD; Alexandre Avran, MD; Ioannis Tsiafoutis, MD, PhD
A 63-year-old man with stable angina was scheduled for elective percutaneous coronary intervention of a chronic total coronary occlusion of the right coronary artery (RCA) with epicardial bridging collaterals from the left circumflex artery...
A 63-year-old man with stable angina was scheduled for elective percutaneous coronary intervention of a chronic total coronary occlusion of the right coronary artery (RCA) with epicardial bridging collaterals from the left circumflex artery...
A 63-year-old man with stable...
07/11/2025
Journal of Invasive Cardiology
Clinical Images
Parallel Wire Technique as a Bailout for Chronic Total Occlusion Recanalization Due to Microcatheter Over-Torquing and Entrapment
01/13/2025
Marco A. Alcántara-Meléndez, MD; Antonio Vargas-Cruz, MD; César L. González-Aguilar, MD; Faustino J. Silva-Centeno, MD; Jesus González-Jasso, MD; Leonel Avendaño-Perez, MD; Rafael Esparza-Corona, MD; Heberto Aquino-Bruno, MD
The authors show an example of microcatheter over-torquing, causing entrapment of the guidewire during recanalization of a chronic total occlusion,.
The authors show an example of microcatheter over-torquing, causing entrapment of the guidewire during recanalization of a chronic total occlusion,.
The authors show an example of...
01/13/2025
Journal of Invasive Cardiology
Clinical Images
Coronary Intervention in Chronic Total Occlusion in the Left Main Coronary Artery
03/04/2024

Yoshinobu Murasato, MD, PhD; Kyohei Meno, MD; Takahiro Mori, MD, PhD

Yoshinobu Murasato, MD, PhD; Kyohei M...
An 83-year-old man who had undergone coronary aorta bypass graft surgery 25 years ago required treatment for new-onset worsening angina.
An 83-year-old man who had undergone coronary aorta bypass graft surgery 25 years ago required treatment for new-onset worsening angina.
An 83-year-old man who had...
03/04/2024
Journal of Invasive Cardiology
Clinical Images
Use of Chronic Total Occlusion Wiring Techniques for Extremely Angulated Side Branch Access
02/13/2024
Tak-Shun Chung, MD, MBBS; Sui-Fung Wong, MBChB; Hiu-Cheong Chow, MBBS
A 75-year-old man was admitted for non-ST-segment elevation myocardial infarction. Coronary angiography showed focal severe disease at obtuse marginal artery and severe medina 1,1,1 bifurcation disease involving proximal to middle left...
A 75-year-old man was admitted for non-ST-segment elevation myocardial infarction. Coronary angiography showed focal severe disease at obtuse marginal artery and severe medina 1,1,1 bifurcation disease involving proximal to middle left...
A 75-year-old man was admitted...
02/13/2024
Journal of Invasive Cardiology
Clinical Images
Ping-Pong Guide Catheter Technique for Facilitating Antegrade Crossing of a Chronic Total Occlusion
11/17/2023
Michalis Koutouzis, MD, PhD; Theodoros Zografos, MD, PhD; Konstantina Katsanou, MD; Emmanouil S. Brilakis, MD, PhD, FACC, FAHA, FESC, FSCAI; Ioannis Tsiafoutis, MD
A 60-year-old man was referred for percutaneous coronary intervention of a proximal left circumflex chronic total occlusion with distal filling via epicardial collaterals from the left anterior descending artery. The 30-mm lesion had a...
A 60-year-old man was referred for percutaneous coronary intervention of a proximal left circumflex chronic total occlusion with distal filling via epicardial collaterals from the left anterior descending artery. The 30-mm lesion had a...
A 60-year-old man was referred...
11/17/2023
Journal of Invasive Cardiology
Clinical Images
Percutaneous Coronary Intervention for Left Main Chronic Total Occlusion: Unprotected or Protected Case?
04/01/2023
Marin Pavlov, MD, PhD; Tomislava Bodrozic Dzakic, MD
A 60-year-old male with chronic obstructive pulmonary disease and active smoking was admitted for positive treadmill test. He reported exertional chest pain 4 months ago; however, since then he had been symptom free. Echocardiography showed...
A 60-year-old male with chronic obstructive pulmonary disease and active smoking was admitted for positive treadmill test. He reported exertional chest pain 4 months ago; however, since then he had been symptom free. Echocardiography showed...
A 60-year-old male with chronic...
04/01/2023
Journal of Invasive Cardiology

News

thrombectomy
Penumbra Launches Lightning Flash 3.0 — The Next Evolution in CAVT Technology
01/27/2026
Penumbra recently launched the Lightning Flash® 3.0 Computer Assisted Vacuum Thrombectomy (CAVT™) system, which includes significant upgrades that further advance our leading venous thromboembolism (VTE) platform.
Penumbra recently launched the Lightning Flash® 3.0 Computer Assisted Vacuum Thrombectomy (CAVT™) system, which includes significant upgrades that further advance our leading venous thromboembolism (VTE) platform.
Penumbra recently launched the...
01/27/2026
Cath Lab Digest
AI Cardiac Imaging Software
Study Reveals Stark Disconnect Between Americans’ Desire for Preventive Cardiac Screening and Care They Can Access
01/27/2026
New York, NY – In the lead-up to American Heart Health Month, a new national study reveals a stark disconnect between Americans’ desire for preventive cardiac screening and the care they can access. Despite heart disease remaining the leading...
New York, NY – In the lead-up to American Heart Health Month, a new national study reveals a stark disconnect between Americans’ desire for preventive cardiac screening and the care they can access. Despite heart disease remaining the leading...
New York, NY – In the lead-up to...
01/27/2026
Cath Lab Digest
Patent Foramen Ovale Detection
BURL Concepts Announces First Human Uses of FOQUS Ultrasound System for Patent Foramen Ovale (PFO) Detection
01/27/2026
The FOQUS ultrasound system, powered by SONAS technology, includes a transcranial headset system. The system introduces a new method to assist physicians in diagnosing a PFO, addressing the need for diagnostic tools that are both faster,...
The FOQUS ultrasound system, powered by SONAS technology, includes a transcranial headset system. The system introduces a new method to assist physicians in diagnosing a PFO, addressing the need for diagnostic tools that are both faster,...
The FOQUS ultrasound system,...
01/27/2026
Cath Lab Digest
AI Plaque analysis
Aetna Approves Coverage for Cleerly's AI Cardiovascular Imaging Analysis
01/21/2026
DENVER, CO – Cleerly, focused on AI-based cardiovascular imaging, announced that Aetna will begin covering Cleerly® LABS plaque analysis effective immediately. Aetna, which covers more than 20+ million lives,...
DENVER, CO – Cleerly, focused on AI-based cardiovascular imaging, announced that Aetna will begin covering Cleerly® LABS plaque analysis effective immediately. Aetna, which covers more than 20+ million lives,...
DENVER,...
01/21/2026
Cath Lab Digest
AI Plaque analysis
Coverage Unlocks Reimbursable AI Plaque Quantification With Circle Cardiovascular Imaging's cvi42|Plaque
01/21/2026
CALGARY, Alberta -- Circle Cardiovascular Imaging Inc. (Circle CVI), focused on cardiovascular imaging post-processing, announced that clinical practices using its FDA 510(k)-cleared cvi42 with AI-enabled plaque...
CALGARY, Alberta -- Circle Cardiovascular Imaging Inc. (Circle CVI), focused on cardiovascular imaging post-processing, announced that clinical practices using its FDA 510(k)-cleared cvi42 with AI-enabled plaque...
CALGARY, Alberta -- Circle...
01/21/2026
Cath Lab Digest
Acquisitions
Haemonetics Acquires Vivasure Medical Limited
01/21/2026
Vivasure's PerQseal® Elite system uses a proprietary bioabsorbable patch to seal large-bore (up to 26 F) arteriotomies and venotomies from inside the vessel, offering a sutureless, fully absorbable solution for structural heart and...
Vivasure's PerQseal® Elite system uses a proprietary bioabsorbable patch to seal large-bore (up to 26 F) arteriotomies and venotomies from inside the vessel, offering a sutureless, fully absorbable solution for structural heart and...
Vivasure's PerQseal® Elite...
01/21/2026
Cath Lab Digest
Early CAD Detection
Mammograms and Hidden Heart Disease: Annual Scans Can Detect This Silent Killer and Help Save Lives, but Awareness Is Key
01/21/2026
In the “Mammography and Breast Arterial Calcification Trial at Mount Sinai,” doctors are sending letters to patients with high breast artery calcification levels, urging them to see a cardiologist or other doctor for further evaluation to...
In the “Mammography and Breast Arterial Calcification Trial at Mount Sinai,” doctors are sending letters to patients with high breast artery calcification levels, urging them to see a cardiologist or other doctor for further evaluation to...
In the “Mammography and Breast...
01/21/2026
Cath Lab Digest
Radiation Protection Systems
Cathpax Demonstrates Ability to Offer Interventional Physicians Unmatched Level of Radiation Protection Thanks to First-of-Its-Kind NOVARAD Clinical Study
01/21/2026
Final results of NOVARAD clinical study show that use of Nova-X® full-body, team-wide radiation protection system reduces dose received by main operator in interventional neuroradiology by a factor of eleven.
Final results of NOVARAD clinical study show that use of Nova-X® full-body, team-wide radiation protection system reduces dose received by main operator in interventional neuroradiology by a factor of eleven.
Final results of NOVARAD...
01/21/2026
Cath Lab Digest
Technology & Health Literacy
ECRI: Misuse of AI Chatbots Tops Annual List of Health Tech Hazards
01/21/2026
ECRI experts say that chatbots have suggested incorrect diagnoses, recommended unnecessary testing, promoted subpar medical supplies, and even invented body parts in response to medical questions while sounding like a trusted expert.
ECRI experts say that chatbots have suggested incorrect diagnoses, recommended unnecessary testing, promoted subpar medical supplies, and even invented body parts in response to medical questions while sounding like a trusted expert.
ECRI experts say that chatbots...
01/21/2026
Cath Lab Digest
CAD Risk Factors
North Carolina State University Study Finds Police-Related Stress Associated With Physical Markers of Cardiovascular Health Risk for Black Women
01/19/2026
The paper, “Police-Related Stress and Carotid Intima-Media Thickness Among African American Women,” is published in the journal Biopsychosocial Science and Medicine.
The paper, “Police-Related Stress and Carotid Intima-Media Thickness Among African American Women,” is published in the journal Biopsychosocial Science and Medicine.
The paper, “Police-Related...
01/19/2026
Cath Lab Digest

Bangalore top 10
Author Interview
Editor’s 2025 Top 10: Outcomes With Distal Transradial Access in Patients With Advanced Chronic Kidney Disease
02/02/2026
Sripal Bangalore, MD, MHA; Deepak L. Bhatt, MD, MPH, FACC, FAHA, FESC, MSCAI
Dr Deepak L. Bhatt, editor-in-chief of the Journal of Invasive Cardiology, catches up with Dr Sripal Bangalore about his Editor’s 2025 Top 10 article, “Outcomes With Distal Transradial Access in Patients With Advanced Chronic Kidney Disease.”
Dr Deepak L. Bhatt, editor-in-chief of the Journal of Invasive Cardiology, catches up with Dr Sripal Bangalore about his Editor’s 2025 Top 10 article, “Outcomes With Distal Transradial Access in Patients With Advanced Chronic Kidney Disease.”
Dr Deepak L. Bhatt,...
02/02/2026
Journal of Invasive Cardiology
Editor's 2025 Top 10
Editor's Message
Editor’s 2025 Top 10
02/02/2026
Deepak L. Bhatt, MD, MPH, FACC, FAHA, FESC, MSCAI
Dr Deepak L. Bhatt, Editor-in-Chief of JIC, presents the Top 10 Articles from 2025.
Dr Deepak L. Bhatt, Editor-in-Chief of JIC, presents the Top 10 Articles from 2025.
Dr Deepak L. Bhatt,...
02/02/2026
Journal of Invasive Cardiology
Original Contribution
Early Outcomes of the Myval Octacor Transcatheter Heart Valve in Transcatheter Aortic Valve Implantation: A Single-Center Study From Serbia
01/30/2026
Valentina Balint, MD; Mihajlo Farkic, MD; Jovan Petrovic, MD; Matija Furtula, MD; Milos D. Babic, MD; Dragan Topic, MD; Ida Subotic, MD; Vladimir Zobenica, MD; Alfonso Ielasi, MD; Luca Testa, MD, PhD; Milovan Bojic, MD, PhD; Aleksandra Nikolic, MD, PhD
This study evaluated the early safety and performance of the new Myval Octacor Transcatheter Heart Valve (Meril Life Sciences).
This study evaluated the early safety and performance of the new Myval Octacor Transcatheter Heart Valve (Meril Life Sciences).
This study evaluated the early...
01/30/2026
Journal of Invasive Cardiology
Sovari Figure 1
Clinical Videos
Right Internal Jugular Pulsed Field Ablation for Atrial Fibrillation in a Patient With an Inferior Vena Cava Filter
01/29/2026
Jeong Hwan J. Kim, MD; Leili Pourafkari, MD; Jonathan Lalezari, MD; Ali Sovari, MD
Video Supplement to "Right Internal Jugular Pulsed Field Ablation for Atrial Fibrillation in a Patient With an Inferior Vena Cava Filter" (Clinical Image).
Video Supplement to "Right Internal Jugular Pulsed Field Ablation for Atrial Fibrillation in a Patient With an Inferior Vena Cava Filter" (Clinical Image).
Video Supplement to "Right...
01/29/2026
Journal of Invasive Cardiology
Clinical Images
Right Internal Jugular Pulsed Field Ablation for Atrial Fibrillation in a Patient With an Inferior Vena Cava Filter
01/29/2026
Jeong Hwan J. Kim, MD; Leili Pourafkari, MD; Jonathan Lalezari, MD; Ali Sovari, MD
A 77-year-old man with peripheral arterial disease, sick sinus syndrome, hypertension, and paroxysmal atrial fibrillation (AF) presented for rhythm control. He had a normally functioning dual-chamber pacemaker but had frequent symptomatic AF...
A 77-year-old man with peripheral arterial disease, sick sinus syndrome, hypertension, and paroxysmal atrial fibrillation (AF) presented for rhythm control. He had a normally functioning dual-chamber pacemaker but had frequent symptomatic AF...
A 77-year-old man with...
01/29/2026
Journal of Invasive Cardiology
Clinical Images
Septal Coronary Artery Fistula After Implantation of a Left Bundle Branch Area Pacemaker
01/28/2026
Nicolas Bradt, MD; Maxim Verlee, MD, PhD(c); Christophe Borin, MD; Hans Vandekerckhove, MD; Laurens De Vos, MD
A 51-year-old man with a mixed-phenotype cardiomyopathy was referred for coronary angiography because of new-onset episodes of ventricular arrythmias. At his initial presentation in 2014, he was diagnosed with hypertrophic cardiomyopathy,...
A 51-year-old man with a mixed-phenotype cardiomyopathy was referred for coronary angiography because of new-onset episodes of ventricular arrythmias. At his initial presentation in 2014, he was diagnosed with hypertrophic cardiomyopathy,...
A 51-year-old man with a...
01/28/2026
Journal of Invasive Cardiology
Bradt Figure
Clinical Videos
Septal Coronary Artery Fistula After Implantation of a Left Bundle Branch Area Pacemaker
01/28/2026
Nicolas Bradt, MD; Maxim Verlee, MD, PhD(c); Christophe Borin, MD; Hans Vandekerckhove, MD; Laurens De Vos, MD
Video Supplement to "Septal Coronary Artery Fistula After Implantation of a Left Bundle Branch Area Pacemaker" (Clinical Image).
Video Supplement to "Septal Coronary Artery Fistula After Implantation of a Left Bundle Branch Area Pacemaker" (Clinical Image).
Video Supplement to "Septal...
01/28/2026
Journal of Invasive Cardiology
thrombectomy
Penumbra Launches Lightning Flash 3.0 — The Next Evolution in CAVT Technology
01/27/2026
Penumbra recently launched the Lightning Flash® 3.0 Computer Assisted Vacuum Thrombectomy (CAVT™) system, which includes significant upgrades that further advance our leading venous thromboembolism (VTE) platform.
Penumbra recently launched the Lightning Flash® 3.0 Computer Assisted Vacuum Thrombectomy (CAVT™) system, which includes significant upgrades that further advance our leading venous thromboembolism (VTE) platform.
Penumbra recently launched the...
01/27/2026
Cath Lab Digest
Heart Failure Devices
CVRx Announces Initiation of BENEFIT-HF, a Landmark Heart Failure Trial Evaluating Barostim in Significantly Expanded Population
01/27/2026
The BENEFIT-HF trial is expected to be one of the largest therapeutic cardiac device trials ever performed in heart failure, randomizing 2,500 patients in approximately 150 centers in the United States and Germany. The primary endpoint will...
The BENEFIT-HF trial is expected to be one of the largest therapeutic cardiac device trials ever performed in heart failure, randomizing 2,500 patients in approximately 150 centers in the United States and Germany. The primary endpoint will...
The BENEFIT-HF trial is expected...
01/27/2026
Cath Lab Digest
HighLife TMVR
Mitral Valve Intervention
HighLife Receives CE Mark Approval for its Transcatheter Mitral Valve Replacement (TMVR) Solution
01/27/2026
Paris – HighLife SAS, a leading MedTech company focused on transcatheter solutions for structural heart disease, today announced that it has received CE Mark approval for the HighLife Transcatheter Mitral Valve Replacement...
Paris – HighLife SAS, a leading MedTech company focused on transcatheter solutions for structural heart disease, today announced that it has received CE Mark approval for the HighLife Transcatheter Mitral Valve Replacement...
Paris – HighLife SAS, a...
01/27/2026
Cath Lab Digest

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