title: Visualization of collateral channels with coronary computed tomography angiography for the retrograde approach in percutaneous coronary intervention for chronic total occlusion.
abstract: BACKGROUND
  There have been no reports about the diagnostic ability of coronary computed tomography angiography (CTA) in evaluating collateral channels used for retrograde chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
  
  
  OBJECTIVE
  We investigated the ability and diagnostic accuracy of coronary CTA compared with invasive coronary angiography to detect collaterals used in retrograde CTO PCI and to compared the success rates for wire crossing between collaterals that are detectable and not detectable in coronary CTA.
  
  
  METHODS
  We retrospectively reviewed data from 43 patients (55 collaterals) who underwent coronary CTA and PCI for CTO with the retrograde approach. We compared the ability of coronary CTA to visualize collaterals to invasive coronary angiography and evaluated the rates of successful wire crossing between CTA-visible and invisible collaterals.
  
  
  RESULTS
  The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of coronary CTA for detecting collaterals which were used for the retrograde approach was 100.0%, 50.0%, 65.9%, 100.0%, and 74.5%, respectively. Guidewire collateral crossing was more successful in CT-visible collaterals than those not detectable in CT (74.1% vs. 46.4%, p = 0.034). There were fewer collateral vessel injuries in CTA-visible collaterals (11.1% vs. 32.1%, p = 0.041).
  
  
  CONCLUSIONS
  Coronary CTA provides good visualization of collaterals used in retrograde CTO PCI. For retrograde guidewire crossing, a higher success rate with fewer complications was observed in CTA-visible collaterals than in those not detectable in coronary CTA.
authors.affiliation: Cardiovascular Center, Japan Community Health Care Organization Hokkaido Hospital, Japan; Department of Nuclear Medicine, Hokkaido University Hospital, Japan.
authors.forename: Teppei
authors.initials: T
authors.lastname: Sugaya
authors.affiliation: Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Japan. Electronic address: norikooyama@med.hokudai.ac.jp.
authors.forename: Noriko
authors.initials: N
authors.lastname: Oyama-Manabe
authors.affiliation: Cardiovascular Center, Japan Community Health Care Organization Hokkaido Hospital, Japan; Graduate School of Medical Science, Kanazawa University, Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Yamaguchi
authors.affiliation: Department of Nuclear Medicine, Hokkaido University Hospital, Japan.
authors.forename: Nagara
authors.initials: N
authors.lastname: Tamaki
authors.affiliation: Cardiovascular Center, Japan Community Health Care Organization Hokkaido Hospital, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Ishimaru
authors.affiliation: Cardiovascular Center, Japan Community Health Care Organization Hokkaido Hospital, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Okabayashi
authors.affiliation: Cardiovascular Center, Japan Community Health Care Organization Hokkaido Hospital, Japan.
authors.forename: Jungo
authors.initials: J
authors.lastname: Furuya
authors.affiliation: Cardiovascular Center, Japan Community Health Care Organization Hokkaido Hospital, Japan.
authors.forename: Toshihito
authors.initials: T
authors.lastname: Yoshida
authors.affiliation: Cardiovascular Center, Japan Community Health Care Organization Hokkaido Hospital, Japan.
authors.forename: Yasumi
authors.initials: Y
authors.lastname: Igarashi
authors.affiliation: Cardiovascular Center, Japan Community Health Care Organization Hokkaido Hospital, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Igarashi
mesh_terms: 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; D061330:Multidetector Computed Tomography; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Chronic total occlusion; Collateral circulation; Coronary angiography; Coronary artery disease; Multi-detector row computed tomography; Percutaneous coronary intervention; Retrograde approach