Impact of calcification length ratio on the intervention for chronic total occlusions.
BACKGROUND
The 64-multislice computed tomography (MSCT) can be used to directly guide the complex percutaneous coronary intervention (PCI) procedure and predict the outcome. This study aimed to determine the possibility of success of angioplasty for chronic total occlusion (CTO) performed on the basis of MSCT results.


METHODS
In this study, we assessed 82 de novo CTO lesions in 67 patients, who were subjected to 64-MSCT before undergoing PCIs. The lesions were either treated with an antegrade approach or a combined bilateral antegrade and retrograde approach. The clinical characteristics of the patients and the angiographic and 64-MSCT parameters associated with the intervention result were analyzed.


RESULTS
In this study, the technical and procedural success rates were 89.0% and 80.5%, respectively. There were significant differences in heavy calcification with the calcification length ratio of >0.5, proximal stump calcification, and distal stump calcification between the technical-success and technical-failure groups (P<0.001, P=0.022, and P=0.003, respectively) as well as between the procedural-success and procedural-failure groups (P<0.001, P=0.042, and P=0.014, respectively). Multivariate analysis showed that heavy calcification was the strong independent parameter that not only influenced technical success (odds ratio [OR]=0.040, 95% confidence interval [CI]=0.006-0.254, P=0.001) but also procedural success (OR=0.127, 95% CI=0.035-0.461, P=0.002).


CONCLUSIONS
Calcification length ratio of >0.5 remains to be the independent negative predictor of both technical and procedural success.
Hsu
Jen Te
JT
Division of Cardiology, Chiayi Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan.
Kyo
Eisho
E
Chu
Chi Ming
CM
Tsuji
Takafumi
T
Watanabe
Satoshi
S
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D002114:Calcinosis / Q000175:diagnosis* / Q000628:therapy*; D002908:Chronic Disease; D017023:Coronary Angiography / Q000379:methods; D054059:Coronary Occlusion / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome