scholarly journals TCT-63: Coronary Computer Tomography Angiography Quantitative Lesion Assessment Compared with Intravascular Ultrasound in Patients With Coronary Artery Disease

2010 ◽  
Vol 56 (13) ◽  
pp. B15
Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1072
Author(s):  
Sorin Giusca ◽  
Moritz Schütz ◽  
Florian Kronbach ◽  
David Wolf ◽  
Peter Nunninger ◽  
...  

Recent technological advances, together with an increasing body of evidence from randomized trials, have placed coronary computer tomography angiography (CCTA) in the center of the diagnostic workup of patients with coronary artery disease. The method was proven reliable in the diagnosis of relevant coronary artery stenosis. Furthermore, it can identify different stages of the atherosclerotic process, including early atherosclerotic changes of the coronary vessel wall, a quality not met by other non-invasive tests. In addition, newer computational software can measure the hemodynamic relevance (fractional flow reserve) of a certain stenosis. In addition, if required, information related to cardiac and valvular function can be provided with specific protocols. Importantly, recent trials have highlighted the prognostic relevance of CCTA in patients with coronary artery disease, which helped establishing CCTA as the first-line method for the diagnostic work-up of such patients in current guidelines. All this can be gathered in one relatively fast examination with minimal discomfort for the patient and, with newer machines, with very low radiation exposure. Herein, we provide an overview of the current technical aspects, indications, pitfalls, and new horizons with CCTA, providing examples from our own clinical practice.


2018 ◽  
Vol 72 (17) ◽  
pp. 2003-2011 ◽  
Author(s):  
Anne-Sophie Schuurman ◽  
Maxime M. Vroegindewey ◽  
Isabella Kardys ◽  
Rohit M. Oemrawsingh ◽  
Hector M. Garcia-Garcia ◽  
...  

2020 ◽  
Vol 8 (4S) ◽  
pp. 104-110 ◽  
Author(s):  
N. A. Kochergin ◽  
V. I. Ganyukov

Background. Today, a number of unresolved issues remain regarding vulnerable coronary plaques, one of which is the need for preventive revascularization.Aim. Evaluation of the appropriateness of preventive revascularization of functionally insignificant lesions of the coronary arteries with signs of vulnerability according to the virtual histology of intravascular ultrasound in patients with stable coronary artery disease.Methods. The prospective randomized study includes patients with stable coronary artery disease and isolated intermediate-grade coronary stenosis. The first step in patients is measured fractional flow reserve to confirm the hemodynamic insignificance of stenosis. Then an intravascular ultrasound is performed to verify signs of plaque vulnerability: a thin-cap fibroatheroma and / or minimum lumen area <4 mm2 and/or plaque burden >70%. After that, patients are randomized into two groups: preventive revascularization or optimal medical therapy. After 12 months, patients undergo repeated intravascular ultrasound and end-point analysis.Results. So far, 10 patients have been included in the study (6 in the preventive revascularization group and 4 in the optimal medical therapy group). No endpoints and complications were recorded in both groups in 30-days follow-up.Conclusion. Intravascular imaging methods can identify vulnerable coronary plaques, which allows you to use a personalized approach in determining treatment tactics, one of which can be preventive revascularization.


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