sabah zidan yousif mohamed wahdan
Asst. Lecturer
Use of Coronary Computed Tomographic Angiography to Facilitate Percutaneous Coronary Intervention of Chronic Total Occlusions
• 2024
Publication Information
Authors
Sabah Zidan Yousef
Prof. Dr. Hesham El Sayed El Shiekh
Dr. Ibrahim Mostafa Helmy
Dr. Mohamed Osama Taha Hussin
Dr. Ahmed Abdullah Torky
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publication.type
Local
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Abstract
Background: Chronic total occlusions (CTOs) in coronary arteries, affecting
approximately 20% of patients with suspected coronary artery disease (CAD), pose
challenges in intervention due to a lower success rate (55–80%) compared to
conventional lesions (>90%). This study aimed to investigate whether multi detector
computed tomography (MDCT) have an impact on the success rate of percutaneous
coronary intervention (PCI) of CTO of coronary arteries. Methods: This was a
prospective study included 100 patients divided into two equal groups of age from 18 -
80 years age groups and of both sexes presented to radiology department, Benha
university hospital and national heart institute. Results: The use of contralateral injection
was significantly higher in Group I (92%) compared to Group II (60%). The success rate
of the procedure was significantly higher in Group I (94%) than in Group II (80%).
Group I experiencing fewer complications (8.2%) compared to Group II (40.8%). Finally,
Group I having a lower mean value of serum creatinine compared to Group II.. The
multivariate model revealed that a history of MI was associated with about eight times
increased risk of failure. The use of CT preprocedural was associated with 86.4% risk
reduction of failure. Conclusion: Computed Tomography Coronary Angiography
(CTCA) has facilitated the diagnosis of CAD by enabling accurate assessment of the
anatomical features without the need for an invasive procedure. CTCA has its uses during
the various steps of CTO PCI, starting from the initial diagnosis, followed by preinterventional planning, and finally, post-procedure outcome and follow-up.
approximately 20% of patients with suspected coronary artery disease (CAD), pose
challenges in intervention due to a lower success rate (55–80%) compared to
conventional lesions (>90%). This study aimed to investigate whether multi detector
computed tomography (MDCT) have an impact on the success rate of percutaneous
coronary intervention (PCI) of CTO of coronary arteries. Methods: This was a
prospective study included 100 patients divided into two equal groups of age from 18 -
80 years age groups and of both sexes presented to radiology department, Benha
university hospital and national heart institute. Results: The use of contralateral injection
was significantly higher in Group I (92%) compared to Group II (60%). The success rate
of the procedure was significantly higher in Group I (94%) than in Group II (80%).
Group I experiencing fewer complications (8.2%) compared to Group II (40.8%). Finally,
Group I having a lower mean value of serum creatinine compared to Group II.. The
multivariate model revealed that a history of MI was associated with about eight times
increased risk of failure. The use of CT preprocedural was associated with 86.4% risk
reduction of failure. Conclusion: Computed Tomography Coronary Angiography
(CTCA) has facilitated the diagnosis of CAD by enabling accurate assessment of the
anatomical features without the need for an invasive procedure. CTCA has its uses during
the various steps of CTO PCI, starting from the initial diagnosis, followed by preinterventional planning, and finally, post-procedure outcome and follow-up.