Journal ArticleDOI
Computed tomography angiography for the interventional cardiologist
Pedro de Araújo Gonçalves,Carlos M. Campos,Carlos M. Campos,Patrick W. Serruys,Hector M. Garcia-Garcia +4 more
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TLDR
It is therefore of utmost importance that interventional cardiologists become familiar with image interpretation and up-to-date regarding several CCTA features, taking advantage of this information in planning the procedure, ultimately leading to improvement in patient outcomes.Abstract:
In recent years, coronary CT angiography (CCTA) has become a widely adopted technique, not only due to its high diagnostic accuracy, but also to the fact that CCTA provides a comprehensive evaluation of the total (obstructive and non-obstructive) coronary atherosclerotic burden. More recently, this technique has become mature, with a large body of evidence addressing its prognostic validation. In addition, CT angiography has moved from the field of ‘imagers’ and clinicians and entered the interventional cardiology arena, aiding in the planning of both coronary and structural heart interventions, being transcatheter aortic valve implantation one of its most successful examples. It is therefore of utmost importance that interventional cardiologists become familiar with image interpretation and up-to-date regarding several CTA features, taking advantage of this information in planning the procedure, ultimately leading to improvement in patient outcomes. On the other hand, the increasing use of CCTA as a gatekeeper for invasive coronary angiography is expected to lead to an increase in the ratio of interventional to diagnostic procedures and significant changes in the daily cath-lab routine. In a foreseeable future, cath-labs will probably offer an invasive procedure only to patients expected to undergo an intervention, perhaps becoming in this change true interventional-labs.read more
Citations
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Journal ArticleDOI
Comparative Effectiveness of CT-Derived Atherosclerotic Plaque Metrics for Predicting Myocardial Ischemia
Hooman Bakhshi,Zahra Meyghani,Satoru Kishi,Tiago A. Magalhães,Andrea Vavere,Pieter H. Kitslaar,Richard T. George,Hiroyuki Niinuma,Johan H. C. Reiber,Aisha Betoko,Matthew B. Matheson,Carlos E. Rochitte,Marcelo F. Di Carli,Christopher Cox,Joao A.C. Lima,Armin Arbab-Zadeh +15 more
TL;DR: Various plaque metrics obtained by cardiac CT predict provocable myocardial ischemia by CT perfusion imaging through their association with maximum percent stenosis, while none had significant incremental value.
Journal ArticleDOI
Integration of non-invasive functional assessments with anatomical risk stratification in complex coronary artery disease: the non-invasive functional SYNTAX score.
Carlos Collet,Yoshinobu Onuma,Yosuke Miyazaki,Marie-Angèle Morel,Patrick W. Serruys,Patrick W. Serruys +5 more
TL;DR: The integration of a novel non-invasive functional coronary assessment with the angiographic risk score in patients with multivessel CAD further refines the identification of patients at risk and provides a recommendation for the Heart Team regarding the treatment strategy.
Journal ArticleDOI
Computed Tomography for Structural Heart Disease and Interventions.
Pascal Thériault-Lauzier,Marco Spaziano,Beatriz Vaquerizo,Jean Buithieu,Giuseppe Martucci,Nicolo Piazza +5 more
TL;DR: This review article outlines the use of MSCT as a tool for diagnosis of structural heart interventions, as well as patient selection, pre-procedural planning, device sizing and post-Procedural assessment.
Journal ArticleDOI
Cardiac Computed Tomography for Comprehensive Coronary Assessment: Beyond Diagnosis of Anatomic Stenosis
TL;DR: The ability of CCTA to provide comprehensive assessment of a patient with suspected CAD is discussed, including functional techniques of stress-rest myocardial perfusion assessment using a vasodilator and a purely post-processing approach that assesses fractional flow reserve derived by CCTa.
Journal ArticleDOI
The Value of 16-cm Wide-Detector Computed Tomography in Coronary Computed Tomography Angiography for Patients With High Heart Rate Variability.
Yuhuan Chen,Donghong Wei,Dou Li,Zhentang Liu,Zhijun Hu,Michelle Li,Yongjun Jia,Yong Yu,Dong Han,Ranzhi Ren,Nan Yu,Taiping He +11 more
TL;DR: Single-heartbeat free-breathing CCTA can be performed for patients with high HRv using 16-cm wide-detector CT scanner to achieve diagnostic image quality with low radiation dose.
References
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Journal ArticleDOI
Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) trial.
Matthew J. Budoff,David A. Dowe,James G. Jollis,Michael J. Gitter,John Sutherland,Edward Halamert,Markus Scherer,Raye L. Bellinger,Arthur Martin,Robert Benton,Augustin Delago,James K. Min +11 more
TL;DR: In this prospective multicenter trial of chest pain patients without known CAD, 64-multidetector row CCTA possesses high diagnostic accuracy for detection of obstructive coronary stenosis at both thresholds of 50% and 70% stenosis.
Journal ArticleDOI
Computed tomographic angiography characteristics of atherosclerotic plaques subsequently resulting in acute coronary syndrome.
Sadako Motoyama,Masayoshi Sarai,Hiroto Harigaya,Hirofumi Anno,Kaori Inoue,Tomonori Hara,Hiroyuki Naruse,Junichi Ishii,Hitoshi Hishida,Nathan D. Wong,Renu Virmani,Takeshi Kondo,Yukio Ozaki,Jagat Narula +13 more
TL;DR: Patients demonstrating positively remodeled coronary segments with low-attenuation plaques on CT angiography were at a higher risk of ACS developing over time when compared with patients having lesions without these characteristics.
Journal ArticleDOI
Low Diagnostic Yield of Elective Coronary Angiography
Manesh R. Patel,Eric D. Peterson,David Dai,J. Matthew Brennan,Rita F. Redberg,H. Vernon Anderson,Ralph G. Brindis,Pamela S. Douglas +7 more
TL;DR: Slightly more than one third of patients without known disease who underwent elective cardiac catheterization had obstructive coronary artery disease, and better strategies for risk stratification are needed to inform decisions and to increase the diagnostic yield of cardiacCatheterization in routine clinical practice.
Journal ArticleDOI
Diagnostic accuracy of 64-slice computed tomography coronary angiography: a prospective, multicenter, multivendor study.
W. Bob Meijboom,Matthijs F.L. Meijs,Joanne D. Schuijf,Maarten J Cramer,Nico R. Mollet,Carlos Van Mieghem,Koen Nieman,Jacob M. van Werkhoven,Jacob M. van Werkhoven,Gabija Pundziute,Gabija Pundziute,Annick C. Weustink,Alexander M. de Vos,Francesca Pugliese,Benno J. Rensing,J. Wouter Jukema,Jeroen J. Bax,Mathias Prokop,Pieter A. Doevendans,M. G. Myriam Hunink,Gabriel P. Krestin,Pim J. de Feyter +21 more
TL;DR: Among patients in whom a decision had already been made to obtain CCA, 64-slice CTCA was reliable for ruling out significant CAD in patients with stable and unstable anginal syndromes.
Journal ArticleDOI
Diagnosis of Ischemia-Causing Coronary Stenoses by Noninvasive Fractional Flow Reserve Computed From Coronary Computed Tomographic Angiograms : Results From the Prospective Multicenter DISCOVER-FLOW (Diagnosis of Ischemia-Causing Stenoses Obtained Via Noninvasive Fractional Flow Reserve) Study
Bon-Kwon Koo,Andrejs Erglis,Joon Hyung Doh,David V. Daniels,Sanda Jegere,Hyo-Soo Kim,Allison Dunning,Tony DeFrance,Alexandra J. Lansky,Jonathan Leipsic,James K. Min +10 more
TL;DR: Noninvasive FFR derived from CCTA is a novel method with high diagnostic performance for the detection and exclusion of coronary lesions that cause ischemia.
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