Values in preoperative assessment of occlusion and intra-operative guidance of 64 row spiral CT in percutaneous coronary intervention for chronic coronary occlusion

Abstract

To instigate the values of 64 row spiral CT in pre-operative assessment of the occlusion and intra-operative guidance in percutaneous coronary intervention for chronic total occlusion (CTO) in coronary heart disease. Fifteen coronary disease patients planned to receive percutaneous coronary intervention underwent 64-row spiral CT-coronary angiography and coronary angiography (CAG). The diagnostic effects of these 2 techniques were compared. Seventeen CTO lesions were confirmed. MSCT succeeded to show the lengths of the 17 CTO lesions with a calcification identification rate of 76.4%, significantly higher than that of the CAG (41.5%). By cross-section examination, MSCT succeeded to detect the occlusion degree of the calcified lesions, and showed that 3 CTO lesions were occluded at a rate < 50%, and 10 lesions at a rate > or = 50%. Twelve complete occlusion lesions in 11 patients underwent PCT, success was seen in 6 of which and failure in the other 6. Univariate analysis showed that the length of lesion, branching at the proximal site, formation of bridging lateral branch, form of occlusion end, and calcification were all not significantly related to the success or failure of intervention. The percentage of the calcification area > or = 50% in the intervention failure group was 83.3%, significantly higher than that in the intervention success group (16.7%, P = 0.05). 3-D images of coronary artery could be obtained by MSCT to show all the complete occlusive lesions. 64-MSCT demonstrates a remarkable ability to identify silicified lesions, can re-establish 3-D images of coronary artery, and effectively guide the intervention therapy.