الفهرس 
? Multi-Detector Computed TomographyOnly 14 pages are availabe for public view
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Abstract
Background: Coronary total occlusion (CTO) has been recognized in nearly 15% of patients undergoing invasive coronary angiography (ICA). CTO represents around 10% of lesions treated by percutaneous coronary intervention.
Objectives: The aim of this study is to investigate whether multi detector computed tomography (MDCT) have an impact on the success rate of percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) of right coronary artery (RCA).
Patients and Methods: This is a Case –Control study, which was conducted on 30 patients divided into two groups, each composed of 15 patients of all age groups and of both sexes, referred to Cardiology department at Ain Shams University Hospitals during the period between August, 2017 and August, 2018 for PCI to CTO RCA. group A: in whom multidetector computed tomography study was performed as routine workup before planned percutaneous coronary revascularization to CTO RCA, group B: in whom percutaneous coronary revascularization to CTO RCA was done based on Coronary angiographic data only.
Results: The present study shows that the interventional success rate was significantly higher in the patient group which had undergone pre-interventional coronary CTA. The success outcome was 14 patients (93.3 %) and only 1 patient failed (6.7%). While the control group had 9 patients with successful outcome (60%) and 6 patients were failed (40%). The P-values equated to (0.03). Our study failed to show any statistical significance of calcification within CTO either regarding its severity or distribution either proximal cap or distal cap. Our results showed that MSCT is similar in sensitivity to CA in visualization of the artery distal to CTO, although results did not show any statically significance of both of them on final procedure outcome. These results may be due to the fact that the artery size distal to CTO even when notably reduced will not be too small to the extent that makes an observed difference in spatial resolution that affect sensitivity of MSCT to visualize it.
Conclusion: The study concluded that MSCT could be utilized to plan PCI procedure upon coronary CTO and predicts its outcomes. It was proven that MSCT can be done prior to CTO intervention procedure especially with the rapidly developing technology that enables us to do it with minimal radiation exposure.