scholarly journals FFRCT for Complex Coronary Artery Disease Treatment Planning: New Opportunities

2018 ◽  
Vol 13 (3) ◽  
pp. 126 ◽  
Author(s):  
Jonathon Leipsic ◽  
Jonathan Weir-McCall ◽  
Philipp Blanke ◽  
◽  
◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Ct Angiography ◽  
Treatment Decision ◽  
Fractional Flow ◽  
Coronary Computed Tomography ◽  
Coronary Ct ◽  
Flow Reserve ◽  
Artery Disease

Coronary computed tomography (CT) is well established for the assessment of symptomatic patients with suspected but not yet confirmed coronary artery disease with high diagnostic accuracy and risk prediction. Until recently, coronary computed tomography angiography (CTA) has played a limited role in the management of complex coronary artery disease (CAD) and in planning revascularisation strategies. With the advent of FFRCT, enabling anatomy and physiology with a single study and the ability to adjudicate lesion specific pressure loss, the potential of combined coronary CT angiography (CCTA) and fractional flow reserve (FFR) computed from non-invasive CT angiography (FFRCT) to inform treatment decision-making and help guide revascularisation has been recognised. In this review, we highlight the evolving role of FFRCT in the management of complex CAD; the opportunities, the data and the unanswered questions.

scholarly journals Noninvasive Assessment of Coronary Artery Disease: Fractional Flow Reserved Derived from Coronary Computed Tomography Angiography (FFRCT)

2016 ◽  
Vol 1 (2) ◽  
pp. 137-141
Author(s):  
Mihaela Rațiu ◽  
Nora Rat ◽  
Sebastian Condrea ◽  
Alexandra Stănescu ◽  
Diana Opincariu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Computed Tomography Angiography ◽  
Coronary Computed Tomography Angiography ◽  
Fractional Flow ◽  
Coronary Computed Tomography ◽  
Flow Reserve ◽  
Artery Disease ◽  
The Impact

AbstractInvasive coronary angiography (ICA) completed by fractional flow reserve (FFR) assessment represents the main procedure that is performed in the decision process for coronary revascularization. Coronary Computed Tomography Angiography (CCTA) is an effective method used in the noninvasive anatomic assessment of coronary artery disease (CAD). However, CCTA tends to overestimate and does not offer hemodynamic data about the coronary lesions. Recent progresses made in the research involving computational fluid dynamics and image modeling permit the evaluation of FFRCT noninvasively, using data obtained in a standard CCTA. Studies have shown an improved precision and discrimination of FFRCT compared to CCTA for the diagnosis of significant coronary artery stenosis. In this review, we aimed to summarize the role of CCTA in CAD evaluation, the impact of FFRCT, the scientific basis of this novel method and its potential clinical applications.

scholarly journals Physiological Evaluation of Anomalous Aortic Origin of a Coronary Artery Using Computed Tomography–Derived Fractional Flow Reserve

2021 ◽  
Author(s):  
Julien Adjedj ◽  
Fabien Hyafil ◽  
Xavier Halna du Fretay ◽  
Patrick Dupouy ◽  
Jean‐Michel Juliard ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Ct Angiography ◽  
Fractional Flow Reserve ◽  
Coronary Ct Angiography ◽  
Functional Evaluation ◽  
Fractional Flow ◽  
Coronary Ct ◽  
Flow Reserve

Background With the emergence of coronary computed tomography (CT) angiography, anomalous aortic origin of a coronary artery (ANOCOR) is more frequently diagnosed. Fractional flow reserve derived from CT (FFRCT) is a noninvasive functional test providing anatomical and functional evaluation of the overall coronary tree. These unique features of anatomical and functional evaluation derived from CT could help for the management of patients with ANOCOR. We aimed to retrospectively evaluate the physiological and clinical impact of FFRCT analysis in the ANOCOR registry population. Methods and Results The ANOCOR registry included patients with ANOCOR detected during invasive coronary angiography or coronary CT angiography between January 2010 and January 2013, with a planned 5‐year follow‐up. We retrospectively performed FFRCT analysis in patients with coronary CT angiography of adequate quality. Follow‐up was performed with a clinical composite end point (cardiac death, myocardial infarction, and unplanned revascularization). We obtained successful FFRCT analyses and 5‐year clinical follow‐up in 54 patients (average age, 60±13 years). Thirty‐eight (70%) patients had conservative treatment, and 16 (30%) patients had coronary revascularization after coronary CT angiography. The presence of an ANOCOR course was associated with a moderate reduction of FFRCT value from 1.0 at the ostium to 0.90±0.10 downstream the ectopic course and 0.82±0.11 distally. No significant difference in FFRCT values was identified between at‐risk and not at‐risk ANOCOR. After a 5‐year follow‐up, only one unplanned percutaneous revascularization was reported. Conclusions The presence of ANOCOR was associated with a moderate hemodynamic decrease of FFRCT values and associated with a low risk of cardiovascular events after a 5‐year follow‐up in this middle‐aged population.

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