Accuracy of RESOLVE score derived from coronary computed tomography versus visual angiography to predict side branch occlusion in percutaneous bifurcation intervention

Opolski, Maksymilian P.; Grodecki, Kajetan; Staruch, Adam D.; Michałowska, Anna; Kępka, Cezary; Wolny, Rafał; Knaapen, Paul; Schumacher, Stefan; Pręgowski, Jerzy; Kruk, Mariusz; Dębski, Mariusz; Dębski, Artur; Michałowska, Ilona; Witkowski, Adam

doi:10.1016/j.jcct.2019.11.007

Cited by 10 publications

(18 citation statements)

References 23 publications

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“…In line with prior studies, we identified the presence of coronary plaque in SB as a robust predictor of its occlusion [2,15,[31][32][33][34]. In our recent paper on CTA-derived RESOLVE score, diameter stenosis of SB before MV stenting and pre-procedural diameter stenosis of bifurcation core achieved the highest diagnostic accuracies for predicting SB occlusion (AUC of 0.720 and 0.725, respectively) [4]. The current analysis demonstrated even higher diagnostic accuracy (AUC of 0.792) for the SB plaque that was visually assessed within the first 5 mm from the SB ostium.…”

Section: Discussionsupporting

confidence: 82%

“…Our study was a post hoc analysis of the participants in the CT-PRECISION registry (NCT03709836), and was approved by the Institutional Review Board and complied with the declaration of Helsinki. The registry was described previously [4]. Out of 400 bifurcation lesions among 363 patients, we excluded 23 lesions with in-stent restenosis in 23 patients, due to the limitations of quantitative plaque analysis in stented segments.…”

Section: Study Design and Populationmentioning

confidence: 99%

“…Treatment of coronary bifurcation lesions accounts for 15-20% of all percutaneous coronary intervention (PCI) procedures [1]. The provisional approach with stenting of the main vessel (MV) first, considered as the preferred strategy in most coronary bifurcation lesions, is associated with an incidence of side branch (SB) occlusion of approximately 10% (a complication that might have serious consequences including clinically significant myocardial infarction and adverse clinical outcomes) [2][3][4][5]. Although studies utilizing intravascular imaging techniques identified plaque and carina shift as two major mechanisms of SB compromise, data on the role of plaque morphology in this complication are scarce [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…Unlike invasive angiography, coronary CTA enables visualization and quantification of atherosclerotic plaque with respect to coronary lumen and vessel geometry [12][13][14][15]. Whereas the distribution of coronary plaque included in the CTA-derived RESOLVE score was found to be predictive of SB occlusion, there is paucity of data on the relationship between plaque morphology and the risk of SB compromise in coronary bifurcation interventions [4]. This study, therefore, aimed to assess the incremental value of quantitative morphological plaque features measured from CTA for predicting SB occlusion in coronary bifurcation intervention.…”

Section: Introductionmentioning

confidence: 99%

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Noncalcified plaque burden quantified from coronary computed tomography angiography improves prediction of side branch occlusion after main vessel stenting in bifurcation lesions: results from the CT-PRECISION registry

et al. 2020

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Objectives To assess the incremental value of quantitative plaque features measured from computed tomography angiography (CTA) for predicting side branch (SB) occlusion in coronary bifurcation intervention. Methods We included 340 patients with 377 bifurcation lesions in the post hoc analysis of the CT-PRECISION registry. Each bifurcation was divided into three segments: the proximal main vessel (MV), the distal MV, and the SB. Segments with evidence of coronary plaque were analyzed using semi-automated software allowing for quantitative analysis of coronary plaque morphology and stenosis. Coronary plaque measurements included calcified and noncalcified plaque volumes, and corresponding burdens (respective plaque volumes × 100%/vessel volume), remodeling index, and stenosis. Results SB occlusion occurred in 28 of 377 bifurcation lesions (7.5%). The presence of visually identified plaque in the SB segment, but not in the proximal and distal MV segments, was the only qualitative parameter that predicted SB occlusion with an area under the curve (AUC) of 0.792. Among quantitative plaque parameters calculated for the SB segment, the addition of noncalcified plaque burden (AUC 0.840, p = 0.003) and low-density plaque burden (AUC 0.836, p = 0.012) yielded significant improvements in predicting SB occlusion. Using receiver operating characteristic curve analysis, optimal cut-offs for noncalcified plaque burden and low-density plaque burden were > 33.6% (86% sensitivity and 78% specificity) and > 0.9% (89% sensitivity and 73% specificity), respectively. Conclusions CTA-derived noncalcified plaque burden, when added to the visually identified SB plaque, significantly improves the prediction of SB occlusion in coronary bifurcation intervention. Trial registration ClinicalTrials.gov Identifier: NCT03709836 registered on October 17, 2018.

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Section: Discussionsupporting

confidence: 82%

Section: Study Design and Populationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Noncalcified plaque burden quantified from coronary computed tomography angiography improves prediction of side branch occlusion after main vessel stenting in bifurcation lesions: results from the CT-PRECISION registry

et al. 2020

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“…With the development of interventional radiology, the geometric parameters of left coronary artery (LCA) bifurcation zone have attracted a large amount of attention because it is highly related to the complex decision-making regarding treatment and the incidence of perioperative and postoperative adverse clinical events [1][2][3]. Additionally, the geometry of the blood vessels has been proven to be one of the causes of atherosclerosis.…”

Section: Introductionmentioning

confidence: 99%

Coronary computed tomography angiography study on the relationship between the Ramus Intermedius and Atherosclerosis in the bifurcation of the left main coronary artery

Zhang

Dong

et al. 2023

BMC Med Imaging

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Objective This study aimed to explore the relationship between the ramus intermedius (RI) and atherosclerosis in the bifurcation of the left coronary artery (LCA). Methods Screening patients who underwent CCTA from January to September 2021, 100 patients with RI (RI group) and 100 patients without RI (no-RI group) were randomly enrolled, Evaluation of RI distribution characteristics and left main coronary artery(LM),Left anterior descending branch(LAD),left circumflex branch(LCX) proximal segment plaque distribution, measurement of LAD-LCX bifurcation angle(∠LAD-LCX),Comparison of the three distribution characteristics with the incidence of plaques in the left main trunk bifurcation area (LM, LAD, LCX) between groups and within the RI group. Results The difference in the incidence of plaques in the proximal LCX and the LM between the RI group and the no-RI group were not statistically significant (P > 0.05). The incidence of plaques in the proximal LAD in the RI group was significantly higher than that in the non-RI group (77% versus 53%, P < 0.05). However, there was no statistically significant difference between the two groups after PSM. A univariate logistic regression analysis revealed that an RI was a risk factor for plaque formation in the proximal LAD (P < 0.001), and a multivariate logistic regression analysis revealed that an RI was not an independent risk factor for plaque formation in the proximal LAD (P > 0.05). When compared within the RI group, the difference in the incidence of plaques in the proximal segment of LAD, the proximal segment of LCX, and the LM among the different distribution groups of RI was not statistically significant, respectively (P > 0.05). Conclusion RI is not an independent risk factor for atherosclerosis in the left coronary artery bifurcation zone, but it may indirectly increase the risk of atherosclerosis in the proximal segment of the LAD.

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Practical utilization of cardiac computed tomography for the success in complex coronary intervention

Sadamatsu

Okutsu

Sumitsuji

et al. 2021

Cardiovasc Interv and Ther

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Accuracy of RESOLVE score derived from coronary computed tomography versus visual angiography to predict side branch occlusion in percutaneous bifurcation intervention

Cited by 10 publications

References 23 publications

Noncalcified plaque burden quantified from coronary computed tomography angiography improves prediction of side branch occlusion after main vessel stenting in bifurcation lesions: results from the CT-PRECISION registry

Noncalcified plaque burden quantified from coronary computed tomography angiography improves prediction of side branch occlusion after main vessel stenting in bifurcation lesions: results from the CT-PRECISION registry

Coronary computed tomography angiography study on the relationship between the Ramus Intermedius and Atherosclerosis in the bifurcation of the left main coronary artery

Practical utilization of cardiac computed tomography for the success in complex coronary intervention

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