Regional calcified plaque score evaluated by multidetector computed tomography for predicting the addition of rotational atherectomy during percutaneous coronary intervention

• Published in: Journal of cardiovascular computed tomography 2016-05, Vol.10 (3), p.221-228
• Main Authors: Sekimoto, Teruo, Akutsu, Yasushi, Hamazaki, Yuji, Sakai, Koshiro, Kosaki, Ryota, Yokota, Hiroyuki, Tsujita, Hiroaki, Tsukamoto, Shigeto, Kaneko, Kyoichi, Sakurai, Masayuki, Kodama, Yusuke, Li, Hui-Ling, Sambe, Takehiko, Oguchi, Katsuji, Uchida, Naoki, Kobayashi, Shinichi, Aoki, Atsushi, Gokan, Takehiko, Kobayashi, Youichi
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Angina, Stable - diagnostic imaging; Angina, Stable - therapy; Area Under Curve; Atherectomy, Coronary; Calcification; Cardiovascular; Chi-Square Distribution; Computed Tomography Angiography - methods; Coronary Angiography - methods; Coronary artery disease; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - therapy; Coronary Vessels - diagnostic imaging; Female; Humans; Male; Middle Aged; Multidetector Computed Tomography - methods; Multidetector computed tomography coronary angiography; Odds Ratio; Patient Selection; Percutaneous Coronary Intervention; Predictive Value of Tests; Quantitative coronary angiographic analysis; Retrospective Studies; Risk Factors; ROC Curve; Rotational atherectomy; Severity of Illness Index; Treatment Outcome; Vascular Calcification - diagnostic imaging; Vascular Calcification - therapy
• ISSN: 1934-5925; 1876-861X
• DOI: 10.1016/j.jcct.2016.01.004

Abstract Background Rotational atherectomy (rotablation) has been proposed as a potentially superior strategy for percutaneous coronary intervention (PCI) in complex and severely calcified lesions. Objectives We hypothesized that a per-lesion coronary artery calcium score determined by multidetector computed tomography (MDCT) would be useful for predicting the requriement for rotablation during PCI. Methods MDCT was performed in patients with stable angina pectoris who were scheduled for first PCI. In 116 consecutive subjects (168 target lesions) with successful PCI, MDCT and quantitative coronary angiography (QCA) data were retrospectively evaluated regarding their ability to predict rotablation. Results PCI without rotablation was performed in 105 patients (154 lesions), and rotablation was added in 11 patients (14 lesions). Patients with rotablation had significantly higher SYNTAX scores (p = 0.007) and total calcium scores (p