Document Detail


Three-dimensional quantitative volumetry of chronic total occlusion plaque using coronary multidetector computed tomography.
MedLine Citation:
PMID:  21068512     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The purpose of the present study was to investigate whether multidetector computed tomography (MDCT) can identify the nature of chronic total occlusion (CTO) plaque, which cannot be measured quantitatively using traditional coronary angiography, and predict the success of percutaneous coronary intervention (PCI).
METHODS AND RESULTS: MDCT and 3-dimensional volumetric radiologic density analysis was performed for 186 consecutive CTO lesions. Plaque characteristics were determined using Hounsfield units (HU) of the image voxels. The remodeling index decreased significantly as the duration of CTO lengthened. Volumetric plaque analysis using HU showed that volumetric fraction of calcification (>324HU) did not, but low-density plaque (<49HU) did decrease significantly as the duration of CTO lengthened. The overall PCI success rate was 77.4% (144/186). In addition to the unknown or >12-month occlusion duration (odds ratio [OR]=3.0, 95% confidence interval [CI]=1.4-6.5, P=0.005), 2 MDCT parameters, that is, lesion length >18mm (OR=2.7, 95%CI=1.1-6.4, P=0.024) and segmental radiologic density >139HU (OR=2.7, 95%CI=1.2-6.4, P=0.021), were independent predictors of PCI failure on multivariate analysis.
CONCLUSIONS: MDCT might be helpful for the prediction of successful CTO PCI. In addition to the occlusion duration, lesion length and high segmental radiologic density measured on MDCT were significant predictors of PCI failure in the present study.
Authors:
Jin-Ho Choi; Young Bin Song; Joo-Yong Hahn; Seung Hyuk Choi; Hyeon-Cheol Gwon; Jung Rae Cho; Yangsoo Jang; YeonHyeon Choe
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2010-11-05
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  75     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2011  
Date Detail:
Created Date:  2011-01-28     Completed Date:  2011-05-23     Revised Date:  2012-01-09    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  366-75     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon, Coronary
Calcinosis / radiography,  therapy
Coronary Angiography*
Coronary Artery Disease / radiography*,  therapy
Coronary Occlusion / radiography*,  therapy
Female
Humans
Imaging, Three-Dimensional*
Male
Middle Aged
Multivariate Analysis
Plaque, Atherosclerotic / radiography*,  therapy
Prospective Studies
Registries
Risk Factors
Tomography, Spiral Computed*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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