Quantification of regional calcium burden in chronic total occlusion by 64-slice multi-detector computed tomography and procedural outcomes of percutaneous coronary intervention

Jung Rae Cho, Youngjin Kim, Chul Min Ahn, Jae Youn Moon, Jung Sun Kim, Hyun Soo Kim, Myeong Kon Kim, Young Guk Ko, Donghoon Choi, Namsik Chung, Kyu Ok Choe, Won Heum Shim, Seung Yun Cho, Yangsoo Jang

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Background: One of the most important reasons for failure of percutaneous coronary intervention (PCI) in chronic total occlusion (CTO) is calcified plaque, which either prevents passage of guide wire or ruptures after balloon inflation. We sought to evaluate whether quantified calcium contents of CTO on multi-detector computed tomography (MDCT) correlate with immediate procedural outcomes. Methods: Sixty-four patients with 72 CTO lesions who underwent 64-slice MDCT prior to PCI were investigated. The lesions were divided into 2 groups according to procedural outcomes (55 lesions with PCI-success group, 17 lesions with PCI-failure group). Clinical, angiographic and MDCT parameters, including regional calcium volume (RCaV), regional calcium score (RCaS), regional calcium equivalent mass (RCaEq), and relative calcium area at the most calcified cross section of CTO (%CaS/CSA), were compared between the two groups. Results: The duration of CTO was shorter in PCI-success group than PCI-failure group (7.16 ± 10.5 vs 15.59 ± 14.92-months, p = 0.011), and the procedural success rate was 76.3%. Regional calcium-related parameters (RCaV 52.86 ± 58.39 vs 7.26 ± 15.27-mm3, p < 0.001; RCaS 72.71 ± 78.4 vs 9.66 ± 20.2, p < 0.001; RCaEq 12.58 ± 12.97 vs 1.84 ± 3.716-mgCaHA, p < 0.001; %CaS/CSA 53.9 ± 20.3 vs 30.4 ± 17.1%, p = 0.009) in the occluded segment were higher and the occlusion length was longer (37.44 ± 27.48 vs 22.00 ± 18.04-mm, p < 0.021) in PCI-failure group compared to PCI-success group. Multivariate regression analysis showed that only %CaS/CSA was a significant determinant of PCI-failure. Conclusions: Precise quantification of regional calcification and measurement of the occluded segment by high resolution MDCT can deliver important information for predicting procedural outcomes in PCI of CTO.

Original languageEnglish
Pages (from-to)9-14
Number of pages6
JournalInternational Journal of Cardiology
Volume145
Issue number1
DOIs
Publication statusPublished - 2010 Nov 5

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Percutaneous Coronary Intervention
Tomography
Calcium
Economic Inflation
Rupture
Multivariate Analysis
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Cho, Jung Rae ; Kim, Youngjin ; Ahn, Chul Min ; Moon, Jae Youn ; Kim, Jung Sun ; Kim, Hyun Soo ; Kim, Myeong Kon ; Ko, Young Guk ; Choi, Donghoon ; Chung, Namsik ; Choe, Kyu Ok ; Shim, Won Heum ; Cho, Seung Yun ; Jang, Yangsoo. / Quantification of regional calcium burden in chronic total occlusion by 64-slice multi-detector computed tomography and procedural outcomes of percutaneous coronary intervention. In: International Journal of Cardiology. 2010 ; Vol. 145, No. 1. pp. 9-14.
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title = "Quantification of regional calcium burden in chronic total occlusion by 64-slice multi-detector computed tomography and procedural outcomes of percutaneous coronary intervention",
abstract = "Background: One of the most important reasons for failure of percutaneous coronary intervention (PCI) in chronic total occlusion (CTO) is calcified plaque, which either prevents passage of guide wire or ruptures after balloon inflation. We sought to evaluate whether quantified calcium contents of CTO on multi-detector computed tomography (MDCT) correlate with immediate procedural outcomes. Methods: Sixty-four patients with 72 CTO lesions who underwent 64-slice MDCT prior to PCI were investigated. The lesions were divided into 2 groups according to procedural outcomes (55 lesions with PCI-success group, 17 lesions with PCI-failure group). Clinical, angiographic and MDCT parameters, including regional calcium volume (RCaV), regional calcium score (RCaS), regional calcium equivalent mass (RCaEq), and relative calcium area at the most calcified cross section of CTO ({\%}CaS/CSA), were compared between the two groups. Results: The duration of CTO was shorter in PCI-success group than PCI-failure group (7.16 ± 10.5 vs 15.59 ± 14.92-months, p = 0.011), and the procedural success rate was 76.3{\%}. Regional calcium-related parameters (RCaV 52.86 ± 58.39 vs 7.26 ± 15.27-mm3, p < 0.001; RCaS 72.71 ± 78.4 vs 9.66 ± 20.2, p < 0.001; RCaEq 12.58 ± 12.97 vs 1.84 ± 3.716-mgCaHA, p < 0.001; {\%}CaS/CSA 53.9 ± 20.3 vs 30.4 ± 17.1{\%}, p = 0.009) in the occluded segment were higher and the occlusion length was longer (37.44 ± 27.48 vs 22.00 ± 18.04-mm, p < 0.021) in PCI-failure group compared to PCI-success group. Multivariate regression analysis showed that only {\%}CaS/CSA was a significant determinant of PCI-failure. Conclusions: Precise quantification of regional calcification and measurement of the occluded segment by high resolution MDCT can deliver important information for predicting procedural outcomes in PCI of CTO.",
author = "Cho, {Jung Rae} and Youngjin Kim and Ahn, {Chul Min} and Moon, {Jae Youn} and Kim, {Jung Sun} and Kim, {Hyun Soo} and Kim, {Myeong Kon} and Ko, {Young Guk} and Donghoon Choi and Namsik Chung and Choe, {Kyu Ok} and Shim, {Won Heum} and Cho, {Seung Yun} and Yangsoo Jang",
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Quantification of regional calcium burden in chronic total occlusion by 64-slice multi-detector computed tomography and procedural outcomes of percutaneous coronary intervention. / Cho, Jung Rae; Kim, Youngjin; Ahn, Chul Min; Moon, Jae Youn; Kim, Jung Sun; Kim, Hyun Soo; Kim, Myeong Kon; Ko, Young Guk; Choi, Donghoon; Chung, Namsik; Choe, Kyu Ok; Shim, Won Heum; Cho, Seung Yun; Jang, Yangsoo.

In: International Journal of Cardiology, Vol. 145, No. 1, 05.11.2010, p. 9-14.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Quantification of regional calcium burden in chronic total occlusion by 64-slice multi-detector computed tomography and procedural outcomes of percutaneous coronary intervention

AU - Cho, Jung Rae

AU - Kim, Youngjin

AU - Ahn, Chul Min

AU - Moon, Jae Youn

AU - Kim, Jung Sun

AU - Kim, Hyun Soo

AU - Kim, Myeong Kon

AU - Ko, Young Guk

AU - Choi, Donghoon

AU - Chung, Namsik

AU - Choe, Kyu Ok

AU - Shim, Won Heum

AU - Cho, Seung Yun

AU - Jang, Yangsoo

PY - 2010/11/5

Y1 - 2010/11/5

N2 - Background: One of the most important reasons for failure of percutaneous coronary intervention (PCI) in chronic total occlusion (CTO) is calcified plaque, which either prevents passage of guide wire or ruptures after balloon inflation. We sought to evaluate whether quantified calcium contents of CTO on multi-detector computed tomography (MDCT) correlate with immediate procedural outcomes. Methods: Sixty-four patients with 72 CTO lesions who underwent 64-slice MDCT prior to PCI were investigated. The lesions were divided into 2 groups according to procedural outcomes (55 lesions with PCI-success group, 17 lesions with PCI-failure group). Clinical, angiographic and MDCT parameters, including regional calcium volume (RCaV), regional calcium score (RCaS), regional calcium equivalent mass (RCaEq), and relative calcium area at the most calcified cross section of CTO (%CaS/CSA), were compared between the two groups. Results: The duration of CTO was shorter in PCI-success group than PCI-failure group (7.16 ± 10.5 vs 15.59 ± 14.92-months, p = 0.011), and the procedural success rate was 76.3%. Regional calcium-related parameters (RCaV 52.86 ± 58.39 vs 7.26 ± 15.27-mm3, p < 0.001; RCaS 72.71 ± 78.4 vs 9.66 ± 20.2, p < 0.001; RCaEq 12.58 ± 12.97 vs 1.84 ± 3.716-mgCaHA, p < 0.001; %CaS/CSA 53.9 ± 20.3 vs 30.4 ± 17.1%, p = 0.009) in the occluded segment were higher and the occlusion length was longer (37.44 ± 27.48 vs 22.00 ± 18.04-mm, p < 0.021) in PCI-failure group compared to PCI-success group. Multivariate regression analysis showed that only %CaS/CSA was a significant determinant of PCI-failure. Conclusions: Precise quantification of regional calcification and measurement of the occluded segment by high resolution MDCT can deliver important information for predicting procedural outcomes in PCI of CTO.

AB - Background: One of the most important reasons for failure of percutaneous coronary intervention (PCI) in chronic total occlusion (CTO) is calcified plaque, which either prevents passage of guide wire or ruptures after balloon inflation. We sought to evaluate whether quantified calcium contents of CTO on multi-detector computed tomography (MDCT) correlate with immediate procedural outcomes. Methods: Sixty-four patients with 72 CTO lesions who underwent 64-slice MDCT prior to PCI were investigated. The lesions were divided into 2 groups according to procedural outcomes (55 lesions with PCI-success group, 17 lesions with PCI-failure group). Clinical, angiographic and MDCT parameters, including regional calcium volume (RCaV), regional calcium score (RCaS), regional calcium equivalent mass (RCaEq), and relative calcium area at the most calcified cross section of CTO (%CaS/CSA), were compared between the two groups. Results: The duration of CTO was shorter in PCI-success group than PCI-failure group (7.16 ± 10.5 vs 15.59 ± 14.92-months, p = 0.011), and the procedural success rate was 76.3%. Regional calcium-related parameters (RCaV 52.86 ± 58.39 vs 7.26 ± 15.27-mm3, p < 0.001; RCaS 72.71 ± 78.4 vs 9.66 ± 20.2, p < 0.001; RCaEq 12.58 ± 12.97 vs 1.84 ± 3.716-mgCaHA, p < 0.001; %CaS/CSA 53.9 ± 20.3 vs 30.4 ± 17.1%, p = 0.009) in the occluded segment were higher and the occlusion length was longer (37.44 ± 27.48 vs 22.00 ± 18.04-mm, p < 0.021) in PCI-failure group compared to PCI-success group. Multivariate regression analysis showed that only %CaS/CSA was a significant determinant of PCI-failure. Conclusions: Precise quantification of regional calcification and measurement of the occluded segment by high resolution MDCT can deliver important information for predicting procedural outcomes in PCI of CTO.

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