title: Dual-Source Computed Tomography for Chronic Total Occlusion of Coronary Arteries.
abstract: OBJECTIVE
  We compared dual-source CT (DSCT) and conventional angiography (CA) in evaluation of chronic total occlusion (CTO) of coronary arteries.
  
  
  BACKGROUND
  Percutaneous coronary intervention (PCI) in CTO is technically difficult and has comparatively lower success rate than intervention in non-occluded artery. Accurate assessment of lesion morphology is an important determinant of PCI success in CTO.
  
  
  METHODS
  Nineteen symptomatic patients (18 men, age: 58.6 ± 10.6 years) with a CTO on CA were subjected to a DSCT (Definition, Siemens, Germany). Heart rate (HR) control was not performed. Dedicated post-processing software was used for lesion analysis on both modalities. Presence of bridging collaterals, stump morphology, calcification, side branch, proximal tortuosity, occlusion length, distal vessel interpretability, and distal lesions were statistically compared.
  
  
  RESULTS
  There were 20 CTOs. HR during DSCT ranged from 53 to 131 bpm. Bridging collaterals were seen in 3/20 (15%) lesions on CA and in none on DSCT. Stump anatomy and side branch were identified equally well. Plaque calcification was identified in 5/20 (25%) lesions on CA and in 12/20 (60%) lesions on DSCT (P = 0.025). Nature and extent of calcification were better visualized on DSCT. No proximal tortuosity was noted. Distal vessel was better interpretable on DSCT (15/20; 75%) compared to CA (9/20; 45%) (P = 0.05). No significant difference in lesion length was noted.
  
  
  CONCLUSIONS
  DSCT performs as well as CA for most features of CTO. Avoidance of need to control HR, ability to better detect and characterize calcium and to interpret distal vessels make it a useful pre-intervention investigation. © 2014 Wiley Periodicals, Inc.
authors.affiliation: Department of Cardiology, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Singh
authors.affiliation: Department of Cardiology, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: Navreet
authors.initials: N
authors.lastname: Singh
authors.affiliation: Department of Cardiac Radiology, All India Institute of Medical Sciences, New Delhi, 110029, India. gulatigurpreet@rediffmail.com.
authors.forename: Gurpreet S
authors.initials: GS
authors.lastname: Gulati
authors.affiliation: Department of Cardiology, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: Sivasubramanian
authors.initials: S
authors.lastname: Ramakrishnan
authors.affiliation: Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: Guresh
authors.initials: G
authors.lastname: Kumar
authors.affiliation: Department of Cardiac Radiology, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: Sanjiv
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Department of Cardiology, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: Vinay K
authors.initials: VK
authors.lastname: Bahl
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003097:Collateral Circulation; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography / Q000379:methods*; D003326:Coronary Circulation; D054059:Coronary Occlusion / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D010865:Pilot Projects; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D012984:Software; D061205:Vascular Calcification / Q000000981:diagnostic imaging
keywords: angiography; coronary; coronary artery disease; electron beam CT/multidetector CT; imaging