Author + information
- Received October 6, 2016
- Revision received January 23, 2017
- Accepted January 25, 2017
- Published online February 5, 2018.
- Akiko Fujino, MDa,∗ (, )
- Satoru Otsuji, MDa,
- Katsuyuki Hasegawa, MDa,
- Toyohiro Arita, RTa,
- Shin Takiuchi, MD, PhDa,
- Kenichi Fujii, MD, PhDa,
- Masanori Yabuki, MD, PhDa,
- Motoaki Ibuki, MDa,
- Shinya Nagayama, MDa,
- Kasumi Ishibuchi, MDa,
- Toshikazu Kashiyama, MDa,
- Rui Ishii, MD, PhDa,
- Hiroto Tamaru, MDa,
- Wataru Yamamoto, MDa,
- Masahiko Hara, MD, PhDb and
- Yorihiko Higashino, MDa
- aDepartment of Cardiology, Higashi Takarazuka Satoh Hospital, Takarazuka, Japan
- bDepartment of Clinical Epidemiology and Biostatics, Osaka University Graduate School of Medicine, Suita, Japan
- ↵∗Address for correspondence:
Dr. Akiko Fujino, Department of Cardiology, Higashi Takarazuka Satoh Hospital, 2-1, Nagaocho, Takarazuka, Hyogo 665-0873, Japan.
Objectives The aim of this study was to compare the ability of conventional versus computed tomography angiography (CTA) to predict procedural success and 30-min wire crossing rates in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) lesions.
Background Coronary CTA can be used to assess the morphology of CTO lesions.
Methods We examined 205 consecutive patients (218 CTO lesions) who underwent coronary CTA pre-PCI. The J-CTO (Multicenter CTO Registry of Japan) score (the sum of the following 5 binary parameters: blunt proximal cap, calcification, bending >45°, and length of occluded segment >20 mm plus previously failed PCI attempt) was calculated using both CTA and conventional coronary angiography and compared.
Results The median patient age was 69 years (interquartile range: 62 to 75 years), 82.4% were male, and a retrograde approach was attempted in 72 (33.0%) cases. The procedural success rate of the CTO-PCI procedures was 82.6%, and 29.4% of cases achieved 30-min wire crossing. The areas under the curve of the CTA-derived J-CTO score for predicting procedural success and 30-min wire crossing were significantly greater than those derived from conventional angiography (0.855 vs. 0.698; p < 0.001 for procedural success and 0.812 vs. 0.692; p < 0.001, for 30-min wire crossing). In addition, the areas under the curve of CTA-derived evaluations of calcification, bending, and occlusion length were significantly higher than those of derived from angiography for predicting procedural success.
Conclusions The CTA-derived J-CTO score was a more useful predictor of both procedural success and 30-min wire crossing than the J-CTO score derived from conventional angiography.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received October 6, 2016.
- Revision received January 23, 2017.
- Accepted January 25, 2017.
- 2018 American College of Cardiology Foundation