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

IF 1.8 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open Pub Date : 2024-12-01 DOI:10.1016/j.ejro.2024.100616

Hua Zhou , Xiaojun Fan , Mingyuan Yuan , Wei Wang, Qiyuan Wu

{"title":"Role of pre-procedure CCTA in predicting failed percutaneous coronary intervention for chronic total occlusions","authors":"Hua Zhou , Xiaojun Fan , Mingyuan Yuan , Wei Wang, Qiyuan Wu","doi":"10.1016/j.ejro.2024.100616","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>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).</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"13 ","pages":"Article 100616"},"PeriodicalIF":1.8000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Radiology Open","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2352047724000716","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

Abstract

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.

查看原文本刊更多论文

术前CCTA在预测慢性全闭塞经皮冠状动脉介入治疗失败中的作用

目的：本研究旨在通过术前冠状动脉计算机断层血管造影（CCTA）联合常规冠状动脉造影（CCA），确定慢性全闭塞（CTOs）的主要病变特征，以预测经皮冠状动脉介入治疗（PCI）失败。方法连续至少有一个原生冠状动脉CTO的患者接受CCTA和CCTA引导的PCI，在PCI之前或期间进行计算机断层扫描。结果本研究共纳入76例CTO患者。76例患者根据PCI结果分为PCI成功组和PCI失败组。PCI成功组62例（81.58 %），PCI失败组14例（18.42 %）。与PCI预后相关的CCTA形态学参数为闭塞长度≥20 mm、口或分叉病变、负重构、微通道和良好的侧支血管（P<0.05）。此外，钝残端、咬合长度≥20 mm、口或分叉病变是与PCI预后相关的CCA形态学参数（P<0.05）。多元回归模型显示，3个独立的负预测因子：钝残肢对CCA (OR: 0.63；95 % ci: 0.23-0.98；p =0.048)， CCTA上咬合长度≥20 mm (OR: 0.37；95 % ci: 0.32-0.71；p <0.001)和CCTA阴性重塑(OR: 0.26；95 % ci: 0.28-0.44；p & lt; 0.001)。结论本研究表明，与单独使用CCTA形态学特征相比，结合CCTA和CCA形态学特征可以提高CTO患者PCI预后的预测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊