Calcification Remodeling Index Characterized by Cardiac CT as a Novel Parameter to Predict the Use of Rotational Atherectomy for Coronary Intervention of Lesions with Moderate to Severe Calcification.
10.3348/kjr.2017.18.5.753
- Author:
Mengmeng YU
1
;
Yuehua LI
;
Wenbin LI
;
Zhigang LU
;
Meng WEI
;
Jiayin ZHANG
Author Information
1. Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China. andrewssmu@msn.com
- Publication Type:Original Article
- Keywords:
Calcification;
Rotational atherectomy;
Computed tomography;
Angiography;
Percutaneous coronary intervention;
Coronary calcium
- MeSH:
Angiography;
Atherectomy, Coronary*;
Calcium;
Coronary Angiography;
Humans;
Incidence;
Percutaneous Coronary Intervention;
Phenobarbital;
Retrospective Studies;
ROC Curve;
Stents
- From:Korean Journal of Radiology
2017;18(5):753-762
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To assess the feasibility of calcification characterization by coronary computed tomography angiography (CCTA) to predict the use of rotational atherectomy (RA) for coronary intervention of lesions with moderate to severe calcification. MATERIALS AND METHODS: Patients with calcified lesions treated by percutaneous coronary intervention (PCI) who underwent both CCTA and invasive coronary angiography were retrospectively included in this study. Calcification remodeling index was calculated as the ratio of the smallest vessel cross-sectional area of the lesion to the proximal reference luminal area. Other parameters such as calcium volume, regional Agatston score, calcification length, and involved calcium arc quadrant were also recorded. RESULTS: A total of 223 patients with 241 calcified lesions were finally included. Lesions with RA tended to have larger calcium volume, higher regional Agatston score, more involved calcium arc quadrants, and significantly smaller calcification remodeling index than lesions without RA. Receiver operating characteristic curve analysis revealed that the best cutoff value of calcification remodeling index was 0.84 (area under curve = 0.847, p < 0.001). Calcification remodeling index ≤ 0.84 was the strongest independent predictor (odds ratio: 251.47, p < 0.001) for using RA. CONCLUSION: Calcification remodeling index was significantly correlated with the incidence of using RA to aid PCI. Calcification remodeling index ≤ 0.84 was the strongest independent predictor for using RA prior to stent implantation.
