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Updated: Dec 8, 2025

Retrograde Perfusion and Filling of Mouse Coronary Vasculature as Preparation for Micro Computed Tomography Imaging
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Preprocedural computed tomography angiography in differentiating chronic total from subtotal coronary occlusions

Joseph Abunassar1, Prasham Dave2, Mohammad Alturki1

  • 1Division of Cardiology, Kingston Health Sciences Center, Queen's University, Kingston, Ontario, Canada.

Journal of Cardiovascular Medicine (Hagerstown, Md.)
|September 17, 2020
PubMed

Insights

Computed tomography angiography (CTA) can differentiate chronic total occlusions (CTOs) from subtotal coronary occlusions (STOs). Key CT-derived parameters include lesion length and collateral presence, aiding revascularization planning.

Area of Science:

  • Cardiology
  • Radiology
  • Interventional Cardiology

Background:

  • Differentiating chronic total occlusions (CTOs) from subtotal coronary occlusions (STOs) is challenging via coronary angiography.
  • Accurate differentiation is crucial for selecting appropriate revascularization techniques and tools.

Purpose of the Study:

  • To evaluate the utility of preprocedural computed tomography angiography (CTA) in distinguishing CTOs from STOs.
  • To identify specific CT-derived parameters that aid in this differentiation.

Main Methods:

  • Systematic review of studies using CT to assist CTO revascularization.
  • Searched Ovid MEDLINE, EMBASE, and EBM reviews (1946-2019).
  • Included 4 studies with 669 patients, excluding case reports/series.

Main Results:

  • CTA can differentiate CTOs from STOs.
  • Significant CT-derived parameters include longer lesion length, greater contrast density difference, presence of collaterals, and the reverse attenuation gradient sign.
  • These findings were based on analysis of 4 studies.

Conclusions:

  • Preprocedural CTA is useful for differentiating CTOs and STOs.
  • Further research is needed to develop validated CT parameters for definitive differentiation.
Abstract

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