CT Coronary Angiography Predicts the Outcome of Percutaneous Coronary Intervention of Chronic Total Occlusion

Soon, Kean; Cox, Nicholas; Wong, Aaron; Chaitowitz, Ivan; MacGregor, Lachlan; Santos, Peter T.; Selvanayagam, Joseph B.; Farouque, H.M. Omar; Rametta, Salvatore; Bell, Kevin W.; Lim, Yean Leng

doi:10.1111/j.1540-8183.2007.00275.x

Cited by 78 publications

(55 citation statements)

References 10 publications

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“…11,20, 25 In the present study, the calcification volume did not affect the procedure result. In addition, although the highest regional radiological density was related to the result, the mean difference between the failure and success groups was <50 HU (Figure 3B).…”

Section: Discussionsupporting

confidence: 41%

Three-Dimensional Quantitative Volumetry of Chronic Total Occlusion Plaque Using Coronary Multidetector Computed Tomography

Choi

Song

Hahn

et al. 2011

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp espite remarkable progress in the technique of percutaneous coronary intervention (PCI), the recanalization of chronic total occlusion (CTO) of native coronary artery remains as one of the major challenges in interventional cardiology. 1-4 The success rates of top level operators are still considerably lower than those achieved in non-occluded coronary arteries or acutely occluded arteries by average-volume operators. 5-7One of the major hurdles of CTO PCI is the inability to visualize the exact vessel course, size, and hardness because of the inability to obtain luminal continuity on traditional coronary angiography. Multidetector computed tomography (MDCT) has been used as a valuable non-invasive tool for evaluation of coronary artery atherosclerotic plaque. 8-14 Furthermore, recent developments in MDCT technology, including increased detectors and dedicated coronary artery analysis software, have enabled sophisticated volumetric plaque analysis on intravascular ultrasound (IVUS). 15, 16 We therefore reasoned that MDCT can provide additional information beyond coronary angiography, and can predict the success of CTO PCI. Background: The purpose of the present study was to investigate whether multidetector computed tomography (MDCT) can identify the nature of chronic total occlusion (CTO) plaque, which cannot be measured quantitatively using traditional coronary angiography, and predict the success of percutaneous coronary intervention (PCI).

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Section: Discussionsupporting

confidence: 41%

Three-Dimensional Quantitative Volumetry of Chronic Total Occlusion Plaque Using Coronary Multidetector Computed Tomography

Choi

Song

Hahn

et al. 2011

Circ J

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“…In older occlusions, the extent of calcium, collagen and elastin exceeds 25% [2]. Calcification > 50% of the vessel diameter is a strong predictor of an unsuccessful procedure [3], increases the rate of complications and stent underexpansion, and correlates with the restenosis rate. The localization of calcification within the occlusion is also of importance.…”

Section: Discussionmentioning

confidence: 99%

“…The localization of calcification within the occlusion is also of importance. Severe calcification of the proximal occlusion site makes a successful PCI more possible when a retrograde approach is used [3].…”

Section: Discussionmentioning

confidence: 99%

Recanalization of chronic total coronary artery occlusions – the role of multi-slice computed tomography.

Bryniarski¹,

Dąbrowski²,

Surowiec³

et al. 2011

pwki

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A b s t r a c tNon-invasive diagnostics of the heart allow one to assess myocardium viability (indication for procedure) and facilitate the choice of strategy and tools used during percutaneous coronary intervention (PCI). We present a case of PCI of chronic total occlusion (CTO) after non-invasive diagnostics, including multi-slice computed tomography (MSCT).K Ke ey y w wo or rd ds s: : chronic total occlusion, percutaneous coronary intervention, multi-slice computed tomography S t r e s z c z e n i eNieinwazyjne metody obrazowania serca pozwalają ocenić żywotność miokardium (ocena wskazań do zabiegu) oraz ułatwić wybór strategii zabiegu i sprzętu stosowanego podczas przezskórnej interwencji wieńcowej (ang. percutaneous coronary interventions, PCI). Przedstawiamy opis zabiegu u pacjenta poddanego PCI przewlekłej okluzji tętnicy wieńcowej po diagnostyce metodami nieinwazyjnymi, w tym po wykonaniu wielorzędowej tomografii komputerowej (multi-slice computed tomography, MSCT).S Sł ło ow wa a k kl lu uc cz zo ow we e: : przewlekłe okluzje tętnic wieńcowych, przezskórne interwencje wieńcowe, wielorzędowa tomografia komputerowa

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“…The ability of CCTA to characterize the distribution of calcium within the lesion is important in predicting the likelihood of PCI success. Cross-sectional calcification, which can only reliably be detected on CCTA, was noted to be more important than the length of calcium deposits in one study (Soon et al 2007). CCTA information can be utilized to plan the strategy of CTO-PCI.…”

Section: Defining Coronary Anatomy Prior To Cto-pcimentioning

confidence: 95%

“…The degree of calcification also has an adverse effect on the success of the procedure. One study showed that the distribution of calcium within the lumen is an independent predictor of failed percutaneous revascularization of CTO (Soon et al 2007). The ability of CCTA to characterize the distribution of calcium within the lesion is important in predicting the likelihood of PCI success.…”

Section: Defining Coronary Anatomy Prior To Cto-pcimentioning

confidence: 99%

Coronary CT Angiography as an Alternative to Invasive Coronary Angiography

Rao¹,

Thompson²

2011

Coronary Angiography - Advances in Noninvasive Imaging Approach for Evaluation of Coronary Artery Disease

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CT Coronary Angiography Predicts the Outcome of Percutaneous Coronary Intervention of Chronic Total Occlusion

Abstract: Heavy transluminal calcification as assessed with CT-CA is an independent predictor of failed PCI of CTO. CT-CA may have a role in the work-up of CTO patients prior to PCI.

Cited by 78 publications

References 10 publications

Three-Dimensional Quantitative Volumetry of Chronic Total Occlusion Plaque Using Coronary Multidetector Computed Tomography

Three-Dimensional Quantitative Volumetry of Chronic Total Occlusion Plaque Using Coronary Multidetector Computed Tomography

Recanalization of chronic total coronary artery occlusions – the role of multi-slice computed tomography.

Coronary CT Angiography as an Alternative to Invasive Coronary Angiography

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