Role of pre-procedure CCTA in predicting failed percutaneous coronary intervention for chronic total occlusions
Purpose: This study aimed to identify major lesion characteristics of chronic total occlusions (CTOs) that predict failed percutaneous coronary intervention (PCI) using pre-procedure coronary computed tomography angiography (CCTA) in combination with conventional coronary angiography (CCA). Methods:...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-12-01
|
| Series: | European Journal of Radiology Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352047724000716 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850257531191951360 |
|---|---|
| author | Hua Zhou Xiaojun Fan Mingyuan Yuan Wei Wang Qiyuan Wu |
| author_facet | Hua Zhou Xiaojun Fan Mingyuan Yuan Wei Wang Qiyuan Wu |
| author_sort | Hua Zhou |
| collection | DOAJ |
| description | Purpose: This study aimed to identify major lesion characteristics of chronic total occlusions (CTOs) that predict failed percutaneous coronary intervention (PCI) using pre-procedure coronary computed tomography angiography (CCTA) in combination with conventional coronary angiography (CCA). Methods: Consecutive patients with at least one CTO of the native coronary arteries received CCTA and CCA-guided PCI, with computed tomography performed before or during PCI. Results: A total of 76 patients with CTO were included in this study. 76 patients were divided into successful and failed PCI groups based on their PCI outcome. There were 62 (81.58 %) patients in the successful PCI group and 14 (18.42 %) in the failed PCI group. The occlusion length ≥20 mm, ostial or bifurcation lesions, negative remodeling, microchannels, and good collateral vessels were the CCTA morphologic parameters associated with PCI outcome (P<0.05). In addition, the blunt stump, occlusion length ≥20 mm, and ostial or bifurcation lesions, were the CCA morphologic parameters associated with PCI outcome (P<0.05). The multivariate regression model showed that the three independent negative predictors: blunt stump on CCA (OR: 0.63; 95 % CI: 0.23–0.98; p =0.048), occlusion length ≥20 mm on CCTA (OR: 0.37; 95 % CI: 0.32–0.71; p <0.001) and negative remodeling on CCTA (OR: 0.26; 95 % CI: 0.28–0.44; p <0.001). Conclusion: Our study demonstrated that combining CCTA and CCA morphologic characteristics could improve PCI outcome prediction in patients with CTO compared to CCTA morphologic features alone. |
| format | Article |
| id | doaj-art-e4631ab301914a2f9620f2ee3b657d9c |
| institution | OA Journals |
| issn | 2352-0477 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | European Journal of Radiology Open |
| spelling | doaj-art-e4631ab301914a2f9620f2ee3b657d9c2025-08-20T01:56:24ZengElsevierEuropean Journal of Radiology Open2352-04772024-12-011310061610.1016/j.ejro.2024.100616Role of pre-procedure CCTA in predicting failed percutaneous coronary intervention for chronic total occlusionsHua Zhou0Xiaojun Fan1Mingyuan Yuan2Wei Wang3Qiyuan Wu4Department of Radiology, Zhoupu Hospital Affiliated to Shanghai Medical and Health College, Shanghai 201318, ChinaDepartment of Radiology, Zhoupu Hospital Affiliated to Shanghai Medical and Health College, Shanghai 201318, ChinaDepartment of Radiology, Zhoupu Hospital Affiliated to Shanghai Medical and Health College, Shanghai 201318, ChinaCorrespondence to: Department of Radiology, Zhoupu Hospital Affiliated to Shanghai Medical and Health College, 1500 Zhouyuan Road, Pudong New Area, Shanghai 201318, China.; Department of Radiology, Zhoupu Hospital Affiliated to Shanghai Medical and Health College, Shanghai 201318, ChinaCorrespondence to: Department of Radiology, Zhoupu Hospital Affiliated to Shanghai Medical and Health College, 1500 Zhouyuan Road, Pudong New Area, Shanghai 201318, China.; Department of Radiology, Zhoupu Hospital Affiliated to Shanghai Medical and Health College, Shanghai 201318, ChinaPurpose: This study aimed to identify major lesion characteristics of chronic total occlusions (CTOs) that predict failed percutaneous coronary intervention (PCI) using pre-procedure coronary computed tomography angiography (CCTA) in combination with conventional coronary angiography (CCA). Methods: Consecutive patients with at least one CTO of the native coronary arteries received CCTA and CCA-guided PCI, with computed tomography performed before or during PCI. Results: A total of 76 patients with CTO were included in this study. 76 patients were divided into successful and failed PCI groups based on their PCI outcome. There were 62 (81.58 %) patients in the successful PCI group and 14 (18.42 %) in the failed PCI group. The occlusion length ≥20 mm, ostial or bifurcation lesions, negative remodeling, microchannels, and good collateral vessels were the CCTA morphologic parameters associated with PCI outcome (P<0.05). In addition, the blunt stump, occlusion length ≥20 mm, and ostial or bifurcation lesions, were the CCA morphologic parameters associated with PCI outcome (P<0.05). The multivariate regression model showed that the three independent negative predictors: blunt stump on CCA (OR: 0.63; 95 % CI: 0.23–0.98; p =0.048), occlusion length ≥20 mm on CCTA (OR: 0.37; 95 % CI: 0.32–0.71; p <0.001) and negative remodeling on CCTA (OR: 0.26; 95 % CI: 0.28–0.44; p <0.001). Conclusion: Our study demonstrated that combining CCTA and CCA morphologic characteristics could improve PCI outcome prediction in patients with CTO compared to CCTA morphologic features alone.http://www.sciencedirect.com/science/article/pii/S2352047724000716TomographyCoronary computed tomography angiography (CCTA)Coronary chronic total occlusion (CTO)Percutaneous coronary intervention (PCI) |
| spellingShingle | Hua Zhou Xiaojun Fan Mingyuan Yuan Wei Wang Qiyuan Wu Role of pre-procedure CCTA in predicting failed percutaneous coronary intervention for chronic total occlusions European Journal of Radiology Open Tomography Coronary computed tomography angiography (CCTA) Coronary chronic total occlusion (CTO) Percutaneous coronary intervention (PCI) |
| title | Role of pre-procedure CCTA in predicting failed percutaneous coronary intervention for chronic total occlusions |
| title_full | Role of pre-procedure CCTA in predicting failed percutaneous coronary intervention for chronic total occlusions |
| title_fullStr | Role of pre-procedure CCTA in predicting failed percutaneous coronary intervention for chronic total occlusions |
| title_full_unstemmed | Role of pre-procedure CCTA in predicting failed percutaneous coronary intervention for chronic total occlusions |
| title_short | Role of pre-procedure CCTA in predicting failed percutaneous coronary intervention for chronic total occlusions |
| title_sort | role of pre procedure ccta in predicting failed percutaneous coronary intervention for chronic total occlusions |
| topic | Tomography Coronary computed tomography angiography (CCTA) Coronary chronic total occlusion (CTO) Percutaneous coronary intervention (PCI) |
| url | http://www.sciencedirect.com/science/article/pii/S2352047724000716 |
| work_keys_str_mv | AT huazhou roleofpreprocedurecctainpredictingfailedpercutaneouscoronaryinterventionforchronictotalocclusions AT xiaojunfan roleofpreprocedurecctainpredictingfailedpercutaneouscoronaryinterventionforchronictotalocclusions AT mingyuanyuan roleofpreprocedurecctainpredictingfailedpercutaneouscoronaryinterventionforchronictotalocclusions AT weiwang roleofpreprocedurecctainpredictingfailedpercutaneouscoronaryinterventionforchronictotalocclusions AT qiyuanwu roleofpreprocedurecctainpredictingfailedpercutaneouscoronaryinterventionforchronictotalocclusions |