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

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.