Comparison of Usefulness of Percutaneous Coronary Intervention Guided by Angiography plus Computed Tomography Versus Angiography Alone Using Intravascular Ultrasound End Points
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...
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| Veröffentlicht in: | The American journal of cardiology 2011-12, Vol.108 (12), p.1728-1734 |
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| creator | Pregowski, Jerzy, MD Kepka, Cezary, MD Kruk, Mariusz, MD Mintz, Gary S., MD Kalinczuk, Lukasz, MD Ciszewski, Michal, MD Ciszewski, Andrzej, MD Wolny, Rafal, MD Szubielski, Michal, MD Chmielak, Zbigniew, MD Demkow, Marcin, MD Norwa-Otto, Bozena, MD Opolski, Maksymilian, MD Tyczynski, Pawel, MD Ruzyllo, Witold, MD Witkowski, Adam, MD |
| description | 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 mm2 , p = 0.110). Minimal stent area tended to be larger (6.62 ± 2.01 vs 5.80 ± 2.02 mm2 , 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 mm2 , 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. |
| doi_str_mv | 10.1016/j.amjcard.2011.07.043 |
| format | Article |
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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 mm2 , p = 0.110). Minimal stent area tended to be larger (6.62 ± 2.01 vs 5.80 ± 2.02 mm2 , 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 mm2 , 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.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2011.07.043</identifier><identifier>PMID: 21906708</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Angioplasty, Balloon, Coronary - methods ; Biological and medical sciences ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular disease ; Cardiovascular system ; Coronary Angiography ; Diseases of the cardiovascular system ; Female ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical imaging ; Medical sciences ; Medical treatment ; Middle Aged ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Single-Blind Method ; Stents ; Tomography, X-Ray Computed ; Treatment Outcome ; Ultrasonography, Interventional</subject><ispartof>The American journal of cardiology, 2011-12, Vol.108 (12), p.1728-1734</ispartof><rights>Elsevier Inc.</rights><rights>2011 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Sequoia S.A. Dec 15, 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c476t-4be36b35a319c5b7ccb0309e46cf3fe258dde83a5f459a4e5508577a795a25613</citedby><cites>FETCH-LOGICAL-c476t-4be36b35a319c5b7ccb0309e46cf3fe258dde83a5f459a4e5508577a795a25613</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002914911024258$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25340037$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21906708$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pregowski, Jerzy, MD</creatorcontrib><creatorcontrib>Kepka, Cezary, MD</creatorcontrib><creatorcontrib>Kruk, Mariusz, MD</creatorcontrib><creatorcontrib>Mintz, Gary S., MD</creatorcontrib><creatorcontrib>Kalinczuk, Lukasz, MD</creatorcontrib><creatorcontrib>Ciszewski, Michal, MD</creatorcontrib><creatorcontrib>Ciszewski, Andrzej, MD</creatorcontrib><creatorcontrib>Wolny, Rafal, MD</creatorcontrib><creatorcontrib>Szubielski, Michal, MD</creatorcontrib><creatorcontrib>Chmielak, Zbigniew, MD</creatorcontrib><creatorcontrib>Demkow, Marcin, MD</creatorcontrib><creatorcontrib>Norwa-Otto, Bozena, MD</creatorcontrib><creatorcontrib>Opolski, Maksymilian, MD</creatorcontrib><creatorcontrib>Tyczynski, Pawel, MD</creatorcontrib><creatorcontrib>Ruzyllo, Witold, MD</creatorcontrib><creatorcontrib>Witkowski, Adam, MD</creatorcontrib><title>Comparison of Usefulness of Percutaneous Coronary Intervention Guided by Angiography plus Computed Tomography Versus Angiography Alone Using Intravascular Ultrasound End Points</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>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 mm2 , p = 0.110). Minimal stent area tended to be larger (6.62 ± 2.01 vs 5.80 ± 2.02 mm2 , 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 mm2 , 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.</description><subject>Aged</subject><subject>Angioplasty, Balloon, Coronary - methods</subject><subject>Biological and medical sciences</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular system</subject><subject>Coronary Angiography</subject><subject>Diseases of the cardiovascular system</subject><subject>Female</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Medical treatment</subject><subject>Middle Aged</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. 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Vascular system</topic><topic>Cardiovascular</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular system</topic><topic>Coronary Angiography</topic><topic>Diseases of the cardiovascular system</topic><topic>Female</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Medical treatment</topic><topic>Middle Aged</topic><topic>Radiodiagnosis. Nmr imagery. Nmr spectrometry</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. 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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 mm2 , p = 0.110). Minimal stent area tended to be larger (6.62 ± 2.01 vs 5.80 ± 2.02 mm2 , 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 mm2 , 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.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>21906708</pmid><doi>10.1016/j.amjcard.2011.07.043</doi><tpages>7</tpages></addata></record> |
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| subjects | Aged Angioplasty, Balloon, Coronary - methods Biological and medical sciences Cardiology Cardiology. Vascular system Cardiovascular Cardiovascular disease Cardiovascular system Coronary Angiography Diseases of the cardiovascular system Female Humans Investigative techniques, diagnostic techniques (general aspects) Male Medical imaging Medical sciences Medical treatment Middle Aged Radiodiagnosis. Nmr imagery. Nmr spectrometry Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Single-Blind Method Stents Tomography, X-Ray Computed Treatment Outcome Ultrasonography, Interventional |
| title | Comparison of Usefulness of Percutaneous Coronary Intervention Guided by Angiography plus Computed Tomography Versus Angiography Alone Using Intravascular Ultrasound End Points |
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