title: Coronary aorto-ostial stenosis analysed by multislice computed tomography: a new tool for percutaneous coronary intervention?
abstract: OBJECTIVE
  Conventional quantitative coronary angiography approaches are limited to quantify complex aorto-ostial stenosis. Multislice CT was able to detect and classify coronary plaques, compared with intravascular ultrasound (IVUS). The aim of the present study was to determine the accuracy of multislice computed tomography (CT) in addition to conventional angiography to identify aorto-ostial coronary stenosis characteristics before revascularisation.
  
  
  RESULTS
  Patients with coronary ostial stenosis were selected for the study. All patients had selective coronary angiography and retrospectively ECG-gated multislice CT (Siemens AG, Munich, Germany). IVUS was performed in patients with ambiguous ostial stenosis revealed by angiography. Forty significant aorto-ostial lesions (38 patients) were analysed by two independent observers in comparison with an expert consensus blinded or not to the coronary CT data sets. Using CT in addition to angiography permitted observers to obtain a strong agreement for assessment of calcified lesions (kappa value 0.75), a good agreement for aortic plaques location and ideal stent position in aorto-ostial coronary stenosis.
  
  
  CONCLUSIONS
  This study shows that CT associated with an angiogram allows a better identification of aorto-ostial plaques morphology and ideal stent position in aorto-ostial coronary stenosis before angioplasty.
authors.affiliation: Department of cardiology, Marie Lannelongue Hospital, Le Plessis Robinson, France. d.pesentirossi@ccmi.fr
authors.forename: David
authors.initials: D
authors.lastname: Pesenti-Rossi
authors.forename: Malik
authors.initials: M
authors.lastname: Chouli
authors.forename: Mostari
authors.initials: M
authors.lastname: Gharbi
authors.forename: Saïd
authors.initials: S
authors.lastname: Ghostine
authors.forename: Yacoub
authors.initials: Y
authors.lastname: Habib
authors.forename: Philippe
authors.initials: P
authors.lastname: Brenot
authors.forename: Claude-Yves
authors.initials: CY
authors.lastname: Angel
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Paul
authors.forename: André
authors.initials: A
authors.lastname: Capderou
authors.forename: Bernard
authors.initials: B
authors.lastname: Lancelin
authors.forename: Christophe
authors.initials: C
authors.lastname: Caussin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000628:therapy; D004562:Electrocardiography; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D015607:Stents; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional