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KMID : 1103720150720030147
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Journal of the Korean Society of Radiology
2015 Volume.72 No. 3 p.147 ~ p.155
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Cardiac Multidetector Row CT before Percutaneous Coronary Intervention as a Treatment Guide for Chronic Total Occlusion1
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Kim Dong-Hun
Choi Dong-Hyun
Suh Jon
Lee Nae-Hee
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Abstract
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Purpose: The goal of this study was to investigate imaging results from a coronary CT angiography (CCTA) in chronic coronary total occlusion (CTO) before percutaneous coronary intervention (PCI).
Materials and Methods: In 74 patients with CTO, 34 patients was evaluated by using a 64-row multidetector CT scanner prior to the PCI and 40 control subjects with CTO, who only took PCI, were included. The multiplanar reformation of the heart chambers and three-dimensional CT images were used for determining an optimal view. We analyzed and evaluated the success rates of PCI, length of occluded vessel, calcified plaques, occluded side-branches, tapered occlusion, > 45° angulation of occluded artery, and myocardial density < 50 Hounsfield unit (HU).
Results: Success rates of PCI in the two groups, the control group and the experimental group, were not statistically different (p > 0.05). The mean length of occluded arteries was measured as 25 ± 11 mm and 26 cases (74%) had an occlusion length > 2 cm. Calcified plaques proximal to occlusion were detected in 19 cases (54%). Occluded side branches, tapered occlusion, > 45° angulation of occluded artery, and myocardial density < 50 HU were in 11 cases (32%), 9 cases (27%), 6 cases (18%), and 5 cases (15%), respectively.
Conclusion: Although there was no correlation between the CCTA findings before PCI and the success rate of PCI, common findings of CCTA in CTO included an occlusion length > 2 cm and calcified plaques proximal to occluded arteries.
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KEYWORD
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Computed Tomography, Angiography, Coronary Vessels, Obstruction, Chronic Total Occlusion
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