| ǥ :
|
ȣ - 510078 1 |
| Could We Predict Successful Percutaneous Coronary Intervention (PCI) in Chronic Total Occlusion (CTO) by 64-Multi-detector Computed Tomography (MDCT) with Regional Calcium Geomorphology |
| 연세대학교 신촌세브란스병원 심장내과 |
| 안철민, 김중선, 고영국, 최동훈, 장양수, 정남식, 심원흠, 조승연 |
Background: Prediction of successful PCI in CTO is depend on mainly guidewire penetration which is closely related to geometry of occluded segment.We intended to evaluate regional calcium related parameters detected by MDCT which could determine procedural outcome of PCI in CTO lesions. Methods: A total of 64 pts (aged 55.4±11.2 yrs, 55 males, 72 lesions) who have CTO at least one major coronary artery were studied who underwent 64 MDCT prior to PCI. Group I (55 lesions) was defined as successful PCI without any complication, whereas group II (17 lesions) was defined as guidewire passage failure or presence of complication during PCI. Calcium-derived parameters in 64-MDCT–regional calcium volume, calcium equivalent mass, calcium score – and percentage calcium area compared to EEM area were calculated by using dedicated software. Results: See the following table (Table 1, Table 2) Conclusion: Regional calcium geomorphology by MDCT can be useful to predict procedural outcome in PCI of CTO. By accurate identification of lesion length and pertinent evaluation of calcium distribution, MDCT could be adopted as pivotal tool for prediction of successful outcome in PCI of CTO.
|
|
Table 1 Lesional characteristics and geomorphology in
CTO segment
|
|
PCI-Success
(N=55) |
PCI-Failure
(N=17) |
P-value |
|
Lesion
length (mm) |
22.0±18.04 |
37.4±27.4 |
0.021* |
|
Total
Ca Score (Agatston score) |
198.8±355.9 |
299.±375.1 |
0.333 |
|
Regional
Ca volume |
7.2±15.2 |
52.8±58.3 |
<0.001* |
|
Regional
Ca score |
9.6±20.2 |
72.7±78.4 |
<0.001* |
|
Regional
Equivalent mass |
1.8±3.7 |
12.5±12.9 |
<0.001* |
|
%
of Ca. area/EEM area |
30.4±17.1 |
53.9±20.3 |
0.009* |
Table 2 Linear
regressional analysis of prediction of succesful interventional
outcome
|
Cut-off value (
determined by ROC curve) |
Sensitivity
(%) |
Specificity
(%) |
|
Lesion
length (mm) |
31.6 |
67 |
56 |
|
RCa
Score |
73.7 |
100 |
67 |
|
RCa
Volume |
52.1 |
100 |
67 |
|
RCa
Equivalent mass |
13.4 |
100 |
67 |
|
% Ca. area/EEM
area |
53.8 |
100 |
67 |
|
|
|
