Imagings of coronary total occlusion using dual-source computed tomography

Abstract

To analyze the imaging characteristics of coronary arteries with total occlusion (TO) lesions shown by dual-source computed tomography CT (DSCT) coronary angiography. The clinical data of patients who were diagnosed as coronary heart disease together with total occlusion lesions between March 2008 and March 2010 were retrospectively analyzed. In a cohort of 140 patients with 152 TO lesions, TO vessels in right coronary artery, left anterior descending artery, left circumflex coronary artery, or left main coronary artery were 68, 48, 20, and 1, respectively. Side branch TO were found in 15 vessels, in which 13 cases were found to be with TO in two coronary arteries. The length of TO was 5-58 mm, mean (16.8 ± 3.9) mm. TO lesions with a length ≥ 1 cm accounted for 91.4%. The appearance of stump in TO were abrupt occlusion (n=68) , blunt occlusion (n=64) , and mouse-tail occlusion (n=20) . Among all the TO lesions, 73% were soft plaque or mainly soft plaque together with minimal calcification. Mixed plaque and calcified plaque were less seen. Ten TO segments presented with dilated lumens were thrombogenesis. There were 25 TO segments angulated or tortuosity, which were most frequently shown in right coronary artery. DSCT only presented 3 TO with clear collateral vessels and no TO with bridge collateral vessels was shown. DSCT can provide most necessary information of coronary TO lesions. Therefore, it can be used to guide surgeries on TO lesions and improve the success rates of surgeries.