SynthesisEuropean radiology2024
The added value of coronary CTA in chronic total occlusion percutaneous coronary intervention: a systematic review and meta-analysis.
Synthesis in European radiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed.
- Comparative validation and clinical utility of an artificial intelligence-based CT-SYNTAX score in complex coronary artery disease.The international journal of cardiovascular imaging · 2026Article
- Anomalous Right Coronary Artery Intervention Guided by Patient-Specific 3-Dimensional Printed Modeling.JACC. Case reports · 2026Article
- Proximal plaque cap morphology in femoropopliteal occlusion affects the primary patency of endovascular therapy: a CT angiography cohort study.La Radiologia medica · 2026Article
- Chronic Total Occlusion Percutaneous Coronary Intervention: A Consensus of the National Heart Center in Collaboration With the Saudi CTO Club of the Saudi Arabian Cardiac Interventional Society.Saudi medical journal · 2026Article
- Coronary CT Angiography for PCI Planning and Guidance: A Comprehensive Narrative Review.Medicina (Kaunas, Lithuania) · 2026Review
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectivesTo systematically investigate and summarize the utility of coronary computed tomographic angiography (CCTA) in the management of chronic total occlusion (CTO)-percutaneous coronary intervention (PCI).
methodsThe authors searched the four databases between 2005 and 2023 for studies investigating the role of CCTA and invasive coronary angiograms (ICA) images when used as the pre-procedural tool for CTO-PCI. Efficacy and safety of CCTA in CTO-PCI treatment as a pre-procedural assessment tool was evaluated.
resultsForty-seven studies were finally chosen for this systematic review. CCTA had a high degree of agreement with ICA when applied for J-CTO scoring system. A J-CTO (Multicenter CTO Registry in Japan) score > 3, together with calcification, occlusion length ≥ 20 mm, blunt stump, and bending > 45° were shared imaging risk factors on both ICA and CCTA for technique failure and guidewire crossing over 30 min. Additionally, negative remodeling and multiple diseased vessel were significant indicators on CCTA. Although patients with pre-procedural CCTA showed a trend of higher success rate and easier guidewire crossing, and CCTA showed a slightly higher predictive accuracy for process success, no significant improvement in post-PCI major adverse cardiac events of using CCTA for assessment has been achieved.
conclusionsCCTA is a safe and effective pre-operative tool of CTO-PCI. Except for the shared imaging risk factors with ICA for a hard CTO-PCI including calcification, occlusion length ≥ 20 mm, blunt stump, bending > 45°, and J-CTO score > 3, factors like negative remodeling and multiple diseased vessel were also recognized as significant pre-operative assessment indicators on CCTA. CLINICAL RELEVANCE STATEMENT: A pre-procedural assessment based on coronary computed tomographic angiography has the potential to aid in the management of chronic total occlusion percutaneous coronary intervention. KEY POINTS: • A coronary computed tomographic angiography-based pre-procedural assessment can help chronic total occlusion-percutaneous coronary intervention management. • The recognized high-risk features detected via coronary computed tomographic angiography and invasive coronary angiograms are comparable in detecting difficult lesions and chronic total occlusion-percutaneous coronary intervention failure. • Coronary computed tomographic angiography has an additional value to be a safe and effective pre-procedural assessment tool for chronic total occlusion-percutaneous coronary intervention.
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