ABSTRACT
The role of MSCT coronary angiography in assistance and guidance of PCI of CTO has been studied in multiple small registries and prospective studies but up till now there is no randomized trial testing this issue. We performed this randomized trial to study the effect of MSCT coronary angiography on the success rate of PCI of CTO and whether it decreases or increases the exposure to radiation and contrast media during PCI. Forty patients were randomized to direct PCI group and MSCT assisted PCI group [20 patients each]. Although MSCT gave a better understanding of the morphologic CTO characteristics and could predict accurately procedural failure, this was not reflected on the success rate and there was no difference between both groups regarding success rate, radiation exposure nor the used contrast media volume during PCI Moreover the patients in the MSCT group were exposed to an extra-dose of radiation and contrast media during MSCT examination. preprocedural MSCT coronary angiography before PCI of CTO did not affect the success rate of the CTO recanalization. MSCT is an excellent predictor of procedural failure of CTO recanalization but at the expense of high dose of radiation exposure and increased usage of contrast media volume