Author + information
- Wael Abuzeid,
- Mohammed Alturki and
- Joseph Abunassar
Revascularization of coronary chronic total occlusions (CTO) can improve symptoms of angina, quality of life and left ventricular systolic function. CTO PCI is often limited by technical challenges related to anatomical proximal and distal vessel ambiguity. Cardiac CTA has an established role in structural heart interventions such as TAVR. However, the role of cardiac CTA to aid in revascularization for CTO is understudied. Our aim was to conduct a systematic review and meta-analysis to study the effect of pre-procedural cardiac CTA on the success of CTO revascularization.
We searched three databases (Ovid MEDLINE, EMBASE, EBM reviews) from January 1, 1947, to December 31, 2016. Studies reporting on the use of computed tomography (CT) to aid in CTO revascularization were included. Case reports and case series were excluded.
We identified 424 articles, and using the Preferred Reporting Items for Systematic Reviews and Meta-analyses method, 3 articles met prespecified inclusion criteria. A meta-analysis showed that pre-procedural cardiac CTA significantly improved procedural success rate (odds ratio 1.893, 95% confidence interval 1.179 to 3.041, Z = 2.640, p <0.05).
The use of pre-procedural CT in planning CTO revascularization significantly improved the success of CTO revascularization.