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Role of pre-procedure CCTA in predicting failed percutaneous coronary intervention for chronic total occlusions

European Journal of Radiology Open, ISSN: 2352-0477, Vol: 13, Page: 100616
2024
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  • Mentions
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Findings from Shanghai Provide New Insights into Radiology (Role of pre-procedure CCTA in predicting failed percutaneous coronary intervention for chronic total occlusions)

2024 DEC 17 (NewsRx) -- By a News Reporter-Staff News Editor at Medical Imaging Daily News -- Investigators discuss new findings in radiology. According to

Article Description

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). 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. 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). 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.

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