title: Comparison of usefulness of percutaneous coronary intervention guided by angiography plus computed tomography versus angiography alone using intravascular ultrasound end points.
abstract: The aim of our study was to assess the impact of coronary computed tomographic angiographic (CTCA) guidance on outcomes of percutaneous coronary intervention (PCI). The study was a randomized single-center trial. Consecutive eligible patients with CTCA-detected significant coronary lesions who were scheduled for PCI were randomized to an angiographically guided versus an angiographically plus computed tomographically guided (ACTG) group. In the ACTG group the operator preliminarily planned PCI based on computed tomographic angiogram. The coprimary end points were minimal stent area and minimal reference lumen area assessed in all patients with intravascular ultrasound performed after achieving optimal angiographic results. Seventy-one patients (50 men, mean age 65 ± 8 years) were randomized. After invasive angiography, PCI of 32 lesions (30 patients) in the ACTG and in 32 lesions (30 patients) in the angiographically guided group was performed. A stented segment length was longer and nominal stent diameter tended to be larger in the ACTG group (23.8 ± 6.7 vs 19.5 ± 6.5 mm, p = 0.01; 3.27 ± 0.44 vs 3.09 ± 0.41 mm(2), p = 0.110). Minimal stent area tended to be larger (6.62 ± 2.01 vs 5.80 ± 2.02 mm(2), p = 0.100) and the smallest peri-stent reference lumen area was significantly larger in the ACTG group (6.76 ± 3.01 vs 5.0 ± 1.62 mm(2), p = 0.006) with a smaller plaque burden (50 ± 16% vs 58 ± 13%, p = 0.025). In conclusion, CTCA analysis before PCI significantly influences treatment strategy and results in better lesion coverage as defined by intravascular criteria.
authors: Institute of Cardiology, Warsaw, Poland. jerzypregowski74@gmail.com
authors: Jerzy
authors: J
authors: Pregowski
authors: Cezary
authors: C
authors: Kepka
authors: Mariusz
authors: M
authors: Kruk
authors: Gary S
authors: GS
authors: Mintz
authors: Lukasz
authors: L
authors: Kalinczuk
authors: Michal
authors: M
authors: Ciszewski
authors: Andrzej
authors: A
authors: Ciszewski
authors: Rafal
authors: R
authors: Wolny
authors: Michal
authors: M
authors: Szubielski
authors: Zbigniew
authors: Z
authors: Chmielak
authors: Marcin
authors: M
authors: Demkow
authors: Bozena
authors: B
authors: Norwa-Otto
authors: Maksymilian
authors: M
authors: Opolski
authors: Pawel
authors: P
authors: Tyczynski
authors: Witold
authors: W
authors: Ruzyllo
authors: Adam
authors: A
authors: Witkowski
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional