Learning Objectives: Chronic total occlusion is defined as the total or subtotal interruption of flow in an epicardial vessel with a duration of at least 3 months prior to observation. Conventional angiography does not allow accurate length measurement of the occluded segment. MDCT-CA allows reliable 3-D length measurement of coronary segments and can assess the characteristics of coronary plaque tissue. The aim is to illustrate how MDCT-CA may aid in pre procedural assessment of CTO patients undergoing a percutaneous recanalisation attempt. Background: Among 480 consecutive patients studied with MDCT-CA in a two years period, 21 consecutive patients (17 M, 4 F, mean age 64 YO) were analysed. For each patient the segment occluded, the length of stenosis, and type of stenosis (calcified or lipid rich plaque) was recorded. Each patient was studied with Conventional Coronary Angiography within 15 days. Concordance between the two techniques was evaluated by means of Spearman test. Imaging Findings or Procedure Details: Mid RCA occluded was described in 16/21 cases, mid LAD in 9/21, LCX in 6/21. Mean length resulted 3.2 mm, mixed in 8/31, lipid rich in 4/31. Good agreement was observed to CA (rho=0.892), and revascularization procedure was successful in 1/21 cases. 11/21 patients were sent to by-pass surgery. Conclusion: MDCT-CA is useful in the pre-procedural planning to more easily select the best coronary view to facilitate the visualization of the lesions.
Percutaneous Recanalisation Of Coronary Chronic Total Occlusion: Pre Procedural Road Mapping With Mdct Coronary Angiography (Mdct-Ca)
MALAGO', Roberto;POZZI MUCELLI, Roberto
2011-01-01
Abstract
Learning Objectives: Chronic total occlusion is defined as the total or subtotal interruption of flow in an epicardial vessel with a duration of at least 3 months prior to observation. Conventional angiography does not allow accurate length measurement of the occluded segment. MDCT-CA allows reliable 3-D length measurement of coronary segments and can assess the characteristics of coronary plaque tissue. The aim is to illustrate how MDCT-CA may aid in pre procedural assessment of CTO patients undergoing a percutaneous recanalisation attempt. Background: Among 480 consecutive patients studied with MDCT-CA in a two years period, 21 consecutive patients (17 M, 4 F, mean age 64 YO) were analysed. For each patient the segment occluded, the length of stenosis, and type of stenosis (calcified or lipid rich plaque) was recorded. Each patient was studied with Conventional Coronary Angiography within 15 days. Concordance between the two techniques was evaluated by means of Spearman test. Imaging Findings or Procedure Details: Mid RCA occluded was described in 16/21 cases, mid LAD in 9/21, LCX in 6/21. Mean length resulted 3.2 mm, mixed in 8/31, lipid rich in 4/31. Good agreement was observed to CA (rho=0.892), and revascularization procedure was successful in 1/21 cases. 11/21 patients were sent to by-pass surgery. Conclusion: MDCT-CA is useful in the pre-procedural planning to more easily select the best coronary view to facilitate the visualization of the lesions.
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