Using a SPOT ROI Function to Minimize Radiation During Chronic Total Occlusion Percutaneous Coronary Interventions

Masataka Yoshinaga; Takashi Muramatsu; Yuto Kondo; Akane Miyazaki; Taishi Fukushima; Yoshihiro Sobue; Yoshinori Narukawa; Wakaya Fujiwara; Kenya Nasu; Eiichi Watanabe

doi:10.1016/j.jaccas.2025.103526

Using a SPOT ROI Function to Minimize Radiation During Chronic Total Occlusion Percutaneous Coronary Interventions

JACC Case Rep. 2025 May 28;30(12):103526. doi: 10.1016/j.jaccas.2025.103526.

Authors

Affiliations

¹ Department of Cardiology, Fujita Health University Bantane Hospital, Aichi, Japan. Electronic address: yoshinaga.mm1021@gmail.com.
² Department of Cardiology, Fujita Health University Hospital, Aichi, Japan.
³ Department of Radiology, Fujita Health University Bantane Hospital, Aichi, Japan.
⁴ Department of Cardiology, Fujita Health University Bantane Hospital, Aichi, Japan.
⁵ Department of Cardiology, Mie Heart Center, Mie, Japan.

Abstract

Objective: This study highlights a case in which we performed a complex percutaneous coronary intervention on a 60-mm chronic total occlusion lesion with a remarkably low radiation dose by using the SPOT region of interest (SPOT ROI) function available on the Alphenix Evolve Edition X-ray system (Canon Medical Systems).

Key steps: Fluoroscopy was conducted exclusively using SPOT ROI from the start of guiding catheter engagement. The wire successfully traversed the chronic total occlusion lesion with SPOT ROI. Despite a fluoroscopy time of 71 min, the total radiation dose was kept at 990 mGy, remaining <1 Gy.

Potential pitfalls: The SPOT ROI function is only available on the Alphenix Evolve Edition X-ray system and cannot be used with other X-ray equipment.

Take-home message: This case suggests that SPOT ROI can be leveraged to safely reduce radiation during complex percutaneous coronary intervention.

Keywords: SPOT region of interest; chronic total occlusion; coronary artery disease; low-dose exposure; new technology; percutaneous coronary intervention; radiation exposure.

Publication types

Case Reports