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European Radiology
Published in: European Radiology 10/2015

01-10-2015 | Cardiac

Impact of lesion morphology on angiographic and clinical outcomes in patients with chronic total occlusion after recanalization with drug-eluting stents: a multislice computed tomography study

Authors: Tsuyoshi Ito, Etsuo Tsuchikane, Kenya Nasu, Yoriyasu Suzuki, Masashi Kimura, Mariko Ehara, Mitsuyasu Terashima, Yoshihisa Kinoshita, Maoto Habara, Takahiko Suzuki, Nobuyuki Ohte

Published in: European Radiology | Issue 10/2015

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Abstract

Objectives

The aim of this study was to investigate the multislice computed tomography (MSCT) parameters associated with adverse outcomes after chronic total occlusion percutaneous coronary intervention (CTO-PCI) with drug-eluting stents.

Methods

A total of 285 patients who underwent MSCT before CTO-PCI were analyzed. Lesion morphology was assessed with MSCT. Angiographic restenosis, reocclusion, and MACE (a composite of cardiac death, myocardial infarction, stent thrombosis, and target lesion revascularization) were analyzed.

Results

MACE was observed in 36 patients (13.6 %). Occlusion length was greater (39.5 ± 19.9 mm vs. 22.3 ± 13.7 mm, p < 0.01), minimal vessel area smaller (11.2 ± 5.7 mm2 vs. 14.5 ± 5.6 mm2, p < 0.01), and severe calcification more common (36 % vs. 12 %, p < 0.01) in the MACE group compared to the non-MACE group. We defined occluded length >25.4 mm, minimal vessel area <11.9 mm2, which were identified by receiver operating characteristic analysis, and severe calcification as CT-derived risk factors. Angiographic restenosis (60 % vs. 12 % vs. 7 %, p < 0.01), reocclusion (29 % vs. 2 % vs. 2 %, p < 0.01), and MACE (43 % vs. 6 % vs. 3 %, p < 0.01) were more common in patients with 2 or more risk factors than in those with 1 or 0.

Conclusions

MSCT characteristics associated with adverse outcomes after CTO-PCI were occlusion length, minimal vessel area, and severe calcification.

Key points

• Percutaneous coronary intervention of chronic total occlusion remains a challenge.
• The parameters related to adverse outcomes after CTO-PCI have not been clarified.
• MSCT can provide useful information associated with adverse outcomes after CTO-PCI.
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Metadata
Title
Impact of lesion morphology on angiographic and clinical outcomes in patients with chronic total occlusion after recanalization with drug-eluting stents: a multislice computed tomography study
Authors
Tsuyoshi Ito
Etsuo Tsuchikane
Kenya Nasu
Yoriyasu Suzuki
Masashi Kimura
Mariko Ehara
Mitsuyasu Terashima
Yoshihisa Kinoshita
Maoto Habara
Takahiko Suzuki
Nobuyuki Ohte
Publication date
01-10-2015
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 10/2015
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-3706-3

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