How to estimate a coronary stenosis using CTA?

Author(s):  
Monica Arzanauskaite
Keyword(s):  
2016 ◽  
Vol 11 (1) ◽  
pp. 11
Author(s):  
Sudheer Koganti ◽  
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◽  
◽  
Tushar Kotecha ◽  
...  

Intracoronary imaging has the capability of accurately measuring vessel and stenosis dimensions, assessing vessel integrity, characterising lesion morphology and guiding optimal percutaneous coronary intervention (PCI). Coronary angiography used to detect and assess coronary stenosis severity has limitations. The 2D nature of fluoroscopic imaging provides lumen profile only and the assessment of coronary stenosis by visual estimation is subjective and prone to error. Performing PCI based on coronary angiography alone is inadequate for determining key metrics of the vessel such as dimension, extent of disease, and plaque distribution and composition. The advent of intracoronary imaging has offset the limitations of angiography and has shifted the paradigm to allow a detailed, objective appreciation of disease extent and morphology, vessel diameter, stent size and deployment and healing after PCI. It has become an essential tool in complex PCI, including rotational atherectomy, in follow-up of novel drug-eluting stent platforms and understanding the pathophysiology of stent failure after PCI (e.g. following stent thrombosis or in-stent restenosis). In this review we look at the two currently available and commonly used intracoronary imaging tools – intravascular ultrasound and optical coherence tomography – and the merits of each.


Circulation ◽  
1995 ◽  
Vol 92 (9) ◽  
pp. 2446-2456 ◽  
Author(s):  
Yukio Ozaki ◽  
David Keane ◽  
Patrick W. Serruys

2021 ◽  
Author(s):  
Yong Kyun Kim ◽  
Chae Won Jang ◽  
Soon Ho Kwon ◽  
Jae Hoon Kim ◽  
Amir Lerman ◽  
...  

2020 ◽  
Vol 13 (14) ◽  
pp. 1727-1729
Author(s):  
Carlos H. Salazar ◽  
Nieves Gonzalo ◽  
Adem Aksoy ◽  
Maria Natalia Tovar Forero ◽  
Holger Nef ◽  
...  

2021 ◽  
Vol 77 (18) ◽  
pp. 1018
Author(s):  
Ryo Takano ◽  
Yoshiharu Fujimori ◽  
Daisuke Yokota ◽  
Naoki Koike ◽  
Tomoko Baba ◽  
...  

Fluids ◽  
2021 ◽  
Vol 6 (4) ◽  
pp. 165
Author(s):  
Jie Yi ◽  
Fang-Bao Tian ◽  
Anne Simmons ◽  
Tracie Barber

Cardiovascular disease is one of the world’s leading causes of morbidity and mortality. Fractional flow reserve (FFR) was proposed in the 1990s to more accurately evaluate the functional severity of intermediate coronary stenosis, and it is currently the gold standard in cardiac catheterization laboratories where coronary pressure and flow are routinely obtained. The clinical measurement of FFR relies on a pressure wire for the recording of pressures; however, in computational fluid dynamics studies, an FFR is frequently predicted using a wire-absent model. We aim to investigate the influence of the physical presence of a 0.014-inch (≈0.36 mm) pressure wire in the calculation of virtual FFR. Ideal and patient-specific models were simulated with the absence and presence of a pressure wire. The computed FFR reduced from 0.96 to 0.93 after inserting a wire in a 3-mm non-stenosed (pipe) ideal model. In mild stenotic cases, the difference in FFR between the wire-absent and wire-included models was slight. The overestimation in severe case was large but is of less clinical significance because, in practice, this tight lesion does not require sophisticated measurement to be considered critical. However, an absence of the pressure wire in simulations could contribute to an over-evaluation for an intermediate coronary stenosis.


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